Most Relevant Information
Provider Data
| NPI Number: | 1003270083 |
| Provider Name: | CARA JANSEN RD |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | 86041657 |
Most Important Dates
| Enumeration Date: | 04/06/2016 |
| Last Updated: | 01/07/2018 |
Provider Practice Location
18001 N 79TH AVE STE A12
GLENDALE
AZ
853088398
Practice Location Phone/Fax
| Phone: | 6233996825 |
| Fax: | 6235053474 |
Provider Mailing Location
14045 N 7TH ST STE 4
PHOENIX
AZ
850224387
Provider Mailing Phone/Fax
| Phone: | 6233996825 |
| Fax: | 6235053474 |