Individual
JESSICA ZIEBART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
405 SHOREVIEW DR, PORT HUENEME, CA 93041-3421
(805) 479-9783
Mailing address
405 SHOREVIEW DR, PORT HUENEME, CA 93041-3421
(805) 479-9783
Taxonomy
Speciality
Code
Description
License number
State
132700000X
Dietary Manager
—
—
133NN1002X
Nutrition Education Nutritionist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
EIN
INTERNAL REVENUE SERVICE
—
Enumeration date
11/08/2021
Last updated
11/08/2021
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