Provider Demographics
NPI:1447523634
Name:CHO, JANNY (RD, LDN, CLC)
Entity type:Individual
Prefix:MRS
First Name:JANNY
Middle Name:
Last Name:CHO
Suffix:
Gender:F
Credentials:RD, LDN, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46071 HALL RD
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20166-9366
Mailing Address - Country:US
Mailing Address - Phone:240-498-3694
Mailing Address - Fax:
Practice Address - Street 1:10334 FAIRFAX BLVD
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-2248
Practice Address - Country:US
Practice Address - Phone:240-498-3694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-17
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDI100001130133V00000X
928284133V00000X
MDDX3210133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD130061000Medicaid