Individual
JAYALAKSHMI PERIASAMY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3200 KEARNEY ST, FREMONT, CA 94538-2299
(510) 498-2184
Mailing address
325 DISTEL CIR, LOS ALTOS, CA 94022-1408
(510) 498-2184
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86295319
CA
Other
Enumeration date
12/05/2023
Last updated
02/02/2024
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