Provider Demographics
NPI:1619353554
Name:BARTELL, JO GARFIELD (MS, RD)
Entity Type:Individual
Prefix:
First Name:JO
Middle Name:GARFIELD
Last Name:BARTELL
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1970 SUTTER ST
Mailing Address - Street 2:#107
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-6107
Mailing Address - Country:US
Mailing Address - Phone:858-967-5686
Mailing Address - Fax:
Practice Address - Street 1:1970 SUTTER ST
Practice Address - Street 2:#107
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-6107
Practice Address - Country:US
Practice Address - Phone:858-967-5686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-03
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1066626133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered