Provider Demographics
NPI:1255005906
Name:PICCININI, JULIA ROSE (RDN)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:ROSE
Last Name:PICCININI
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 MIDCREST RD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-1814
Mailing Address - Country:US
Mailing Address - Phone:510-318-2922
Mailing Address - Fax:
Practice Address - Street 1:506 MIDCREST RD
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94610-1814
Practice Address - Country:US
Practice Address - Phone:510-318-2922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-05
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86064788133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered