Provider Demographics
NPI:1811676612
Name:ARNOLD, JOANNA (RD)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:ARNOLD
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 1:4953 W POINT LOMA BLVD APT 2
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92107-1336
Mailing Address - Country:US
Mailing Address - Phone:312-402-2062
Mailing Address - Fax:
Practice Address - Street 1:4953 W POINT LOMA BLVD APT 2
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92107-1336
Practice Address - Country:US
Practice Address - Phone:312-402-2062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered