Provider Demographics
NPI:1245479047
Name:DEMARCHI, JOANNE (MA, RD, IBCLC)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:DEMARCHI
Suffix:
Gender:F
Credentials:MA, RD, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22332 SHADOW RDG
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-4817
Mailing Address - Country:US
Mailing Address - Phone:949-202-7570
Mailing Address - Fax:
Practice Address - Street 1:22332 SHADOW RDG
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92692-4817
Practice Address - Country:US
Practice Address - Phone:949-202-7570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-18
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No174N00000XOther Service ProvidersLactation Consultant, Non-RN