Provider Demographics
NPI:1447534219
Name:GOOLEY, JOANNE (RD)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:GOOLEY
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2173 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95818-4309
Mailing Address - Country:US
Mailing Address - Phone:916-497-0212
Mailing Address - Fax:
Practice Address - Street 1:1650 RESPONSE RD
Practice Address - Street 2:HEALTH EDUCATION DEPARTMENT
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95815-4807
Practice Address - Country:US
Practice Address - Phone:916-607-1650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-28
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA867560133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered