Organization
GROWINGPATHS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEE-IN MAO PH.D., R.D, (OWNER)
(510) 557-3710
Entity
Organization
Contact information
Practice address
782 LONGFELLOW DR, FREMONT, CA 94539-6310
(510) 557-3710
(510) 657-7842
Mailing address
PO BOX 3354, FREMONT, CA 94539-0335
(510) 557-3710
(510) 657-7842
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
133NN1002X
Nutrition Education Nutritionist
—
—
133V00000X
Registered Dietitian
Primary
710410
IL
133VN1004X
Pediatric Nutrition Registered Dietitian
710410
IL
133VN1005X
Renal Nutrition Registered Dietitian
710410
IL
133VN1006X
Metabolic Nutrition Registered Dietitian
710410
IL
Other
Enumeration date
11/27/2008
Last updated
11/27/2008
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