Provider Demographics
NPI:1982842522
Name:BJURMAN, JODI W (RD, CDE)
Entity Type:Individual
Prefix:MRS
First Name:JODI
Middle Name:W
Last Name:BJURMAN
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18511 MISSION VIEW DR
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-2902
Mailing Address - Country:US
Mailing Address - Phone:408-779-9422
Mailing Address - Fax:408-779-4113
Practice Address - Street 1:18511 MISSION VIEW DR
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-2902
Practice Address - Country:US
Practice Address - Phone:408-779-9422
Practice Address - Fax:408-779-4113
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
629966133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered