JENNIFER L LOGAN (NPI# 1639620768) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639620768 |
| Entity Type | Individual |
| Full Name | JENNIFER L LOGAN |
| Other Name | JENNIFER L HRUBY |
| Credential | RD, CDE |
| Practice Address |
1701 4th St Ste 210 Santa Rosa CA 95404-3661 |
| Mailing Address |
3536 Mendocino Ave Ste 200 Santa Rosa CA 95403-3634 |
| Practice Telephone | 7075787530 |
| Practice Fax Number | 7075787533 |
| Mailing Telephone | 7075256485 |
| Mailing Fax Number | 7075736918 |
| Enumeration Date | 2016-10-24 |
| Last Update Date | 2018-11-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | Dietary & Nutritional Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194335620 | Jennifer Logan | Nurse Practitioner | 424 Scotts Way, Augusta, GA 30909-3135 | 2020-08-10 |
| 1124370226 | Jennifer D Logan | Counselor | 103 Appaloosa Cir, Goodfield, IL 61742-9300 | 2012-10-12 |
| 1598039984 | Jennifer Dawn Logan | Registered Nurse | 1706 N Semoran Blvd Ste 100, Orlando, FL 32807 | 2012-03-02 |
| 1861763948 | Jennifer Rose Logan | Counselor | 316 Chadwick Pl, Helena, AL 35080-3141 | 2012-01-20 |
| 1457344376 | Jennifer Coleman Logan | Family Medicine | 241b Freedom Way, Jacksonville Va Cboc, Jacksonville, NC 28544-1418 | 2005-08-25 |
| 1427051671 | Jennifer P Logan | Ophthalmology | 6715 Antigua Dr, Fort Collins, CO 80525-9433 | 2005-05-23 |
| 1184138539 | Jennifer Logan | Student in an Organized Health Care Education/Training Program | 405 Main St Fl 1, Danbury, CT 06810-4710 | 2017-11-21 |
| 1487102034 | Jennifer Leigh Logan | Nurse Practitioner | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2016-09-12 |
| 1831582667 | Jennifer A Logan | Dietitian, Registered | 125 Baldwin Ave, Suite 200, Charlotte, NC 28204-3370 | 2015-03-18 |
| 1184043903 | Jennifer Kristin Logan | Radiology | 1400 S Orange Ave, Orlando, FL 32806-2134 | 2014-04-09 |
| Street Address |
1701 4TH ST STE 210 |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95404-3661 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104824994 | Jack Waxman | Internal Medicine | 1701 4th St Ste 210, Santa Rosa, CA 95404-3661 | 2005-07-14 |
| 1871008318 | Northern California Medical Assoc Inc | Dietitian, Registered | 1701 4th St Ste 210, Santa Rosa, CA 95404-3661 | 2017-12-06 |
| 1801348859 | Heather Jeanne Kehres | Physician Assistant | 1701 4th St Ste 210, Santa Rosa, CA 95404-3661 | 2016-10-25 |
| 1477965507 | Isha Shrestha | Internal Medicine | 1701 4th St Ste 210, Santa Rosa, CA 95404-3661 | 2014-05-23 |
| 1134222458 | Kent William Blakely | Internal Medicine | 1701 4th St Ste 210, Santa Rosa, CA 95404 | 2006-09-06 |
| 1497739114 | Yuichiro David Nakai | Internal Medicine | 1701 4th St Ste 210, Santa Rosa, CA 95404-3661 | 2005-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205442217 | David Lee Dutton | Counselor | 201 S. E Street, Santa Rosa, CA 95404 | 2020-09-16 |
| 1114492162 | Jesse Earl Rathbun Jr. | Ophthalmology | 1920 Grace Dr., Santa Rosa, CA 95404 | 2018-10-05 |
| 1568958437 | Bianca Avina | Marriage & Family Therapist | 95 Montgomery Dr. #112, Santa Rosa, CA 95404 | 2018-07-03 |
| 1366940504 | New Leaf Counseling and Psychotherapy | Marriage & Family Therapist | 1030 2n Street, Suite B, Santa Rosa, CA 95404 | 2018-01-23 |
| 1659884864 | Jessica Vargas Lopez | Counselor | 3333 Chanate Road, Santa Rosa, CA 95404 | 2017-11-09 |
| 1982135992 | Gaea Keridwyn Coon | Marriage & Family Therapist | 884 Third Street, Suite D, Santa Rosa, CA 95404 | 2017-03-22 |
| 1376084699 | Empire Traditional Chinese Medicine | Acupuncturist | 1030 Second St, Santa Rosa, CA 95404 | 2017-03-20 |
| 1356888705 | Webster Surgery Center, Lp | Clinic/Center | 730 Bennett Valley Road, Santa Rosa, CA 95404 | 2017-01-24 |
| 1205295979 | Sandra Lee Krikorian | Social Worker | 101 E Street, Suite 312, Santa Rosa, CA 95404 | 2016-02-23 |
| 1396134615 | The Center for Body Oriented Psychotherapy & Wellness | Psychologist | 1626 Fourth Street, Santa Rosa, CA 95404 | 2015-01-12 |
| Find all providers in zip 95404 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164031746 | Guadalupe Orihuela | Dietitian, Registered | 3230 Hoen Ave, Santa Rosa, CA 95405-7527 | 2020-07-29 |
| 1871991109 | Diane Zepaltas | Dietitian, Registered | 365b Tesconi Cir, Santa Rosa, CA 95401-4617 | 2014-12-19 |
| 1962826438 | Alida Peterson | Dietitian, Registered | 5785 Saint Helena Rd, Santa Rosa, CA 95404-9690 | 2014-02-04 |
| 1518307396 | Aileen Mayte Rodriguez | Dietitian, Registered | 1450 Guerneville Rd, Santa Rosa, CA 95403-4107 | 2013-06-26 |
| 1033463260 | Mary Mcdonell | Dietitian, Registered | 365 Tesconi Cir Ste B, Santa Rosa, CA 95401-4617 | 2012-11-09 |
| 1669729778 | Moriah Molling | Dietitian, Registered | 684 Benicia Dr, Santa Rosa, CA 95409-3058 | 2012-08-08 |
| 1043596562 | Cali Kent | Dietitian, Registered | 3920 Millbrook Dr, Santa Rosa, CA 95404-7613 | 2011-10-28 |
| 1801124433 | Joan Elaine Gates | Dietitian, Registered | 365 Tesconi Cir, Suite B, Santa Rosa, CA 95401-4617 | 2009-11-19 |
| 1518182211 | Andy Skrypka | Dietitian, Registered | 365 Tesconi Circle, Suite B, Santa Rosa, CA 95401 | 2007-04-16 |
| 1851422539 | Judith A Hoaglund | Dietitian, Registered | 365 Tesconi Cir # B, Santa Rosa, CA 95401-4617 | 2007-03-07 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95404 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.