Provider Demographics
NPI:1316913841
Name:EMBREE, JANELLE (DIETITIAN)
Entity type:Individual
Prefix:
First Name:JANELLE
Middle Name:
Last Name:EMBREE
Suffix:
Gender:F
Credentials:DIETITIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2120 MADERA RD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-0246
Mailing Address - Country:US
Mailing Address - Phone:916-843-7351
Mailing Address - Fax:916-843-7387
Practice Address - Street 1:2120 MADERA RD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-0246
Practice Address - Country:US
Practice Address - Phone:916-843-7351
Practice Address - Fax:916-843-7387
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA722800133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered