Provider Demographics
NPI:1609992460
Name:HIGGINS, JENNIFER ANNE (RD, CNSD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANNE
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:RD, CNSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4131 GEARY BLVD
Mailing Address - Street 2:ROOM 111
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-3101
Mailing Address - Country:US
Mailing Address - Phone:415-833-3650
Mailing Address - Fax:415-833-8805
Practice Address - Street 1:4131 GEARY BLVD
Practice Address - Street 2:ROOM 111
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-3101
Practice Address - Country:US
Practice Address - Phone:415-833-3650
Practice Address - Fax:415-833-8805
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA886491133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered