Individual
MRS. JENNIFER ROACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
408 PINE ST, MOUNT SHASTA, CA 96067-2126
(530) 926-7196
Mailing address
408 PINE ST, MOUNT SHASTA, CA 96067-2126
(530) 926-7196
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
819436
CA
Other
Enumeration date
03/20/2025
Last updated
06/17/2025
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