Individual
ERIN JORDAN PETTYGROVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
1533 LAGO ST, SAN MATEO, CA 94403-2007
(434) 996-3153
Mailing address
1533 LAGO ST, SAN MATEO, CA 94403-2007
(434) 996-3153
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86070586
CA
Other
Enumeration date
07/25/2018
Last updated
07/25/2018
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