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Individual

MRS. GINA M WHITELEY I

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD, CDE

Contact information

Practice address
3100 DOUGLAS BLVD, ROSEVILLE, CA 95661-3866
(916) 865-1140
Mailing address
8197 KOSSUM WAY, ELK GROVE, CA 95624-4155
(951) 490-2177

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
956089
CA

Other

Enumeration date
10/10/2018
Last updated
10/10/2018
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