Provider Demographics
NPI:1184468266
Name:ESTOURNES, JANELLE MARIE (RD)
Entity type:Individual
Prefix:MS
First Name:JANELLE
Middle Name:MARIE
Last Name:ESTOURNES
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2938 BENNETT VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-5714
Mailing Address - Country:US
Mailing Address - Phone:707-285-7131
Mailing Address - Fax:
Practice Address - Street 1:406 CHINN ST
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-4339
Practice Address - Country:US
Practice Address - Phone:707-285-7131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1044417133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered