Individual
JESSICA KEYS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2170 SOUTH AVE, SOUTH LAKE TAHOE, CA 96150-7026
(530) 543-5823
(530) 543-5821
Mailing address
2170 SOUTH AVE, SOUTH LAKE TAHOE, CA 96150-7026
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
05/08/2015
Last updated
03/28/2017
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