Individual
JACK DYLAN KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RD
Contact information
Practice address
1237 PINEHURST RD, CHULA VISTA, CA 91915-1245
(619) 917-9321
Mailing address
1237 PINEHURST RD, CHULA VISTA, CA 91915-1245
(619) 917-9321
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86296497
CA
Other
Enumeration date
07/23/2025
Last updated
07/23/2025
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