Jodie Elizabeth Wallace, RD

NPI #1316429939 in Antioch, California

Provider Information

NPI Number: 1316429939
Entity Type: Individual
Name: Jodie Elizabeth Wallace, RD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dietitian, Registered
Credential: RD
Enumeration Date: Aug 30, 2018
Last Updated: Aug 30, 2018

Practice Location

Address: 4501 SAND CREEK RD
City: Antioch
State: California
ZIP Code: 94531-8687
Phone: (925) 813-7600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dietitian, Registered	133V00000X	Primary

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