Provider Demographics
NPI:1881348167
Name:GORE, ALANNAH (MPH, RD, LDN)
Entity type:Individual
Prefix:
First Name:ALANNAH
Middle Name:
Last Name:GORE
Suffix:
Gender:
Credentials:MPH, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5755 GLENRIDGE DR UNIT 322
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-2015
Mailing Address - Country:US
Mailing Address - Phone:919-724-1570
Mailing Address - Fax:
Practice Address - Street 1:595 PACIFIC AVE FL 4
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94133-4685
Practice Address - Country:US
Practice Address - Phone:202-250-1482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-07
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDI200001470133V00000X
NCL005290133V00000X
MDDX5570133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered