Provider Demographics
NPI:1942387584
Name:LENNETT, LINDA JOYCE (RD,MS)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:JOYCE
Last Name:LENNETT
Suffix:
Gender:F
Credentials:RD,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 SAINT PAUL DR
Mailing Address - Street 2:
Mailing Address - City:ALAMO
Mailing Address - State:CA
Mailing Address - Zip Code:94507-1648
Mailing Address - Country:US
Mailing Address - Phone:925-855-0150
Mailing Address - Fax:925-362-0806
Practice Address - Street 1:250 SAINT PAUL DR
Practice Address - Street 2:
Practice Address - City:ALAMO
Practice Address - State:CA
Practice Address - Zip Code:94507-1648
Practice Address - Country:US
Practice Address - Phone:925-855-0150
Practice Address - Fax:925-362-0806
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY46167-2133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered