Provider Demographics
NPI:1124182563
Name:VATTUONE, JOAN K (RD)
Entity type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:K
Last Name:VATTUONE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:JOAN
Other - Middle Name:K
Other - Last Name:NOON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD
Mailing Address - Street 1:1936 PEGGY DR
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-3026
Mailing Address - Country:US
Mailing Address - Phone:925-779-5140
Mailing Address - Fax:
Practice Address - Street 1:3400 DELTA FAIR BLVD
Practice Address - Street 2:HEALTH EDUCATION
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-4004
Practice Address - Country:US
Practice Address - Phone:925-779-5140
Practice Address - Fax:925-779-5474
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA877724133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered