Provider Demographics
NPI:1427104710
Name:DURETTE, JULIE (RD, CDE)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:DURETTE
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2524 DONNER WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95818-3933
Mailing Address - Country:US
Mailing Address - Phone:916-454-9126
Mailing Address - Fax:484-414-9126
Practice Address - Street 1:2524 DONNER WAY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95818-3933
Practice Address - Country:US
Practice Address - Phone:916-454-9126
Practice Address - Fax:484-414-9126
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA839197133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered