Provider Demographics
NPI:1215441332
Name:JACALONE, TONI (MS, RDN)
Entity type:Individual
Prefix:MRS
First Name:TONI
Middle Name:
Last Name:JACALONE
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:TONI
Other - Middle Name:
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RDN
Mailing Address - Street 1:2355 MADRONE ST
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-2628
Mailing Address - Country:US
Mailing Address - Phone:805-341-5195
Mailing Address - Fax:805-261-0083
Practice Address - Street 1:2355 MADRONE ST
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-2628
Practice Address - Country:US
Practice Address - Phone:805-341-5195
Practice Address - Fax:805-261-0083
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-28
Last Update Date:2020-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA984116133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered