Provider Demographics
NPI:1821548512
Name:HONG, JOOHEE (MS, RD)
Entity Type:Individual
Prefix:
First Name:JOOHEE
Middle Name:
Last Name:HONG
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 1:2836 LAS PIEDRAS DR
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-5728
Mailing Address - Country:US
Mailing Address - Phone:510-504-4355
Mailing Address - Fax:
Practice Address - Street 1:2836 LAS PIEDRAS DR
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-5728
Practice Address - Country:US
Practice Address - Phone:510-504-4355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-06
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1108457133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered