Provider Demographics
NPI:1336350735
Name:MALEAR, JOCELYN REYNOLDS (RD)
Entity type:Individual
Prefix:
First Name:JOCELYN
Middle Name:REYNOLDS
Last Name:MALEAR
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:BETSY
Other - Middle Name:
Other - Last Name:REYNOLDS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RD
Mailing Address - Street 1:UCSB
Mailing Address - Street 2:STUDENT HEALTH SERVICES
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93106
Mailing Address - Country:US
Mailing Address - Phone:805-893-2289
Mailing Address - Fax:
Practice Address - Street 1:UCSB
Practice Address - Street 2:STUDENT HEALTH SERVICES
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93106-0001
Practice Address - Country:US
Practice Address - Phone:805-893-2289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA720360133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered