Jennifer L Logan, RD, CDE | |
1701 4th St Ste 210, Santa Rosa, CA 95404-3661 | |
(707) 578-7530 | |
(707) 578-7533 |
Full Name | Jennifer L Logan |
---|---|
Gender | Female |
Speciality | Registered Dietitian Or Nutrition Professional |
Experience | 30 Years |
Location | 1701 4th St Ste 210, Santa Rosa, California |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1639620768 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | (* (Not Available)) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Providence Medical Foundation | 8921993205 | 1312 |
Provider Name | Providence Medical Foundation |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1285890624 PECOS PAC ID: 8921993205 Enrollment ID: O20040216001346 |
Mailing Address | Practice Location Address |
---|---|
Jennifer L Logan, RD, CDE 3536 Mendocino Ave, Ste 200, Santa Rosa, CA 95403-3634 Ph: (707) 525-6485 | Jennifer L Logan, RD, CDE 1701 4th St Ste 210, Santa Rosa, CA 95404-3661 Ph: (707) 578-7530 |
Ms. Jessica Anne Rutland, R.D. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 401 Bicentennial Way, Santa Rosa, CA 95403 Phone: 707-393-4787 | |
Sari Bornstein, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 401 Bicentennial Way, Santa Rosa, CA 95403 Phone: 707-393-3506 | |
Mary Mcdonell, RD, RN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 365 Tesconi Cir Ste B, Santa Rosa, CA 95401 Phone: 707-575-6043 | |
Kathryn J Boyd, R.D. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 401 Bicentennial Way, Santa Rosa, CA 95403 Phone: 707-571-4167 | |
Cali Kent, R.D. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 3920 Millbrook Dr, Santa Rosa, CA 95404 Phone: 707-575-3324 Fax: 707-575-3324 | |
Ms. Gail Prosser, RD, CDE Dietitian Medicare: Not Enrolled in Medicare Practice Location: 3925 Old Redwood Hwy, Dept Of Pediatrics, Santa Rosa, CA 95403 Phone: 707-566-5358 Fax: 707-566-5292 | |
Guadalupe Orihuela, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 3230 Hoen Ave, Santa Rosa, CA 95405 Phone: 707-477-4093 |