Provider Demographics
NPI:1861717928
Name:FRANKLIN, IRENE BOYLE (RD)
Entity type:Individual
Prefix:
First Name:IRENE
Middle Name:BOYLE
Last Name:FRANKLIN
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 1:335 CAMILLE CT
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-2644
Mailing Address - Country:US
Mailing Address - Phone:650-799-2575
Mailing Address - Fax:
Practice Address - Street 1:335 CAMILLE CT
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-2644
Practice Address - Country:US
Practice Address - Phone:650-799-2575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-01
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA01031182133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered