Provider Demographics
NPI:1932641743
Name:MOWRER, JANA (MPH, RDN)
Entity Type:Individual
Prefix:
First Name:JANA
Middle Name:
Last Name:MOWRER
Suffix:
Gender:F
Credentials:MPH, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6840 N MAPLE AVE APT 258
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-4587
Mailing Address - Country:US
Mailing Address - Phone:209-769-0440
Mailing Address - Fax:
Practice Address - Street 1:6840 N MAPLE AVE APT 258
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-4587
Practice Address - Country:US
Practice Address - Phone:209-769-0440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-09
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1100138133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered