Individual
JENNIFER LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RDN
Contact information
Practice address
207 S MCDOWELL BLVD # 1063, PETALUMA, CA 94954-3505
(707) 338-2474
(707) 221-1688
Mailing address
207 S MCDOWELL BLVD # 1063, PETALUMA, CA 94954-3505
(707) 338-2474
(707) 221-1688
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
984565
CA
Other
Enumeration date
08/04/2021
Last updated
05/02/2024
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