Individual
MRS. JACLYN GAYLIS KIRSCHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD
Contact information
Practice address
13112 CHAMBORD WAY, SAN DIEGO, CA 92130-5774
(619) 251-4331
Mailing address
PO BOX 910253, SAN DIEGO, CA 92191-0253
(858) 314-8469
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86076553
CA
133VN1201X
Obesity and Weight Management Nutrition Registered Dietitian
86076553
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86076553
ACADEMY NUTRITION DIETETICS
—
Enumeration date
10/30/2018
Last updated
09/05/2020
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