Provider Demographics
NPI:1821127838
Name:GITTER, JASON (RD)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:
Last Name:GITTER
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19360 MOUNTAIN MDW N
Mailing Address - Street 2:
Mailing Address - City:HIDDEN VALLEY LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:95467-8540
Mailing Address - Country:US
Mailing Address - Phone:707-671-4231
Mailing Address - Fax:
Practice Address - Street 1:19360 MOUNTAIN MDW N
Practice Address - Street 2:
Practice Address - City:HIDDEN VALLEY LAKE
Practice Address - State:CA
Practice Address - Zip Code:95467-8540
Practice Address - Country:US
Practice Address - Phone:707-671-4231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA862449133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered