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Individual

JACQUELYN DEGRENDELE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
39500 LIBERTY ST, FREMONT, CA 94538-2211
(408) 887-0854
Mailing address
1245 W CAMPBELL AVE APT 3, CAMPBELL, CA 95008-1734
(408) 887-0854

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1040535
CA

Other

Enumeration date
07/08/2011
Last updated
07/08/2011
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