Doctor Name: | SUSANNE MACANDER ROUGH |
NPI Number: | 1326244468 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSRD |
License Number: | 00963627 |
Business Practice Address: | 39400 Paseo Padre Pkwy Fremont, CA - 945382310 |
Business Phone Number: | 5102487504 |
Business Fax Number: | 5102487057 |
Mailing Address: | 264 S 14th St, SAN JOSE |
State: | CA |
Postal Code: | 951122130 |
Phone Number: | 4082948662 |
Fax Number: | 4082948662 |
NPI Enumeration Date: | 06/25/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 00963627 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |