Geralyn Da Silva

Individual provider Active NPI Registered Dietitian · Jackson, CA

NPI 1306245774 · NPPES record last updated Aug 21, 2014

Key facts

NPI
1306245774
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
351468 (CA)
Practice address
12140 New York Ranch Rd
Jackson, CA 95642-9407
Phone
(209) 257-2400
Fax
(209) 257-2403
NPI assigned
Aug 21, 2014
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
351468CAMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 351468 CA Yes

Addresses

Primary practice location

12140 New York Ranch Rd
Jackson, CA 95642-9407

Mailing address

PO Box 939
Angels Camp, CA 95222-0939
Phone (209) 754-6240

Other providers in Jackson, CA

All providers in Jackson, CA · Registered Dietitian in California

Sources for this page

Verify at the official NPI Registry.