Provider Demographics
NPI:1952538910
Name:GEORGE, JINA ANN (RD,)
Entity Type:Individual
Prefix:
First Name:JINA
Middle Name:ANN
Last Name:GEORGE
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 1:2035 SAN REMO DR
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-3282
Mailing Address - Country:US
Mailing Address - Phone:619-985-6992
Mailing Address - Fax:
Practice Address - Street 1:450 S MELROSE DR
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081-6674
Practice Address - Country:US
Practice Address - Phone:760-227-2392
Practice Address - Fax:760-388-7705
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-17
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA966497133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered