Provider Demographics
NPI:1487911194
Name:ARMSTRONG, JACLYN D (MPH, RDN, ACSM)
Entity type:Individual
Prefix:
First Name:JACLYN
Middle Name:D
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:MPH, RDN, ACSM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1463 OAK GROVE AVE
Mailing Address - Street 2:APT 1
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-4081
Mailing Address - Country:US
Mailing Address - Phone:415-906-9586
Mailing Address - Fax:
Practice Address - Street 1:1040 DOLORES ST
Practice Address - Street 2:APT 103
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-2972
Practice Address - Country:US
Practice Address - Phone:415-906-9586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-19
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered