Provider Demographics
NPI:1174315089
Name:RICE, JILL (FDNP)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:RICE
Suffix:
Gender:F
Credentials:FDNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 374
Mailing Address - Street 2:
Mailing Address - City:LOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:95551-0374
Mailing Address - Country:US
Mailing Address - Phone:707-407-8850
Mailing Address - Fax:
Practice Address - Street 1:3020 H ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-4410
Practice Address - Country:US
Practice Address - Phone:707-407-8850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach