Provider Demographics
NPI:1730343302
Name:HERRMAN, JEANNE K (RD)
Entity type:Individual
Prefix:MRS
First Name:JEANNE
Middle Name:K
Last Name:HERRMAN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 CHADBOUNE DRIVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94506-6178
Mailing Address - Country:US
Mailing Address - Phone:925-648-1623
Mailing Address - Fax:925-648-1623
Practice Address - Street 1:115 CHADBOURNE DRIVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94506-6178
Practice Address - Country:US
Practice Address - Phone:925-648-1623
Practice Address - Fax:925-648-1623
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA344844133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered