Individual
JILL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
501 PETALUMA AVE, SEBASTOPOL, CA 95472-4215
(707) 829-4397
(707) 529-4136
Mailing address
501 PETALUMA AVE, SEBASTOPOL, CA 95472-4215
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
723425
CA
Other
Enumeration date
05/24/2011
Last updated
05/24/2011
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