Provider Demographics
NPI:1013214550
Name:OLIVO, JAMIE JESSOP (RD)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:JESSOP
Last Name:OLIVO
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5199 FELICIA AVE
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550
Mailing Address - Country:US
Mailing Address - Phone:925-337-2428
Mailing Address - Fax:916-574-1001
Practice Address - Street 1:5199 FELICIA AVE
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550
Practice Address - Country:US
Practice Address - Phone:925-337-2428
Practice Address - Fax:916-574-1001
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-18
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered