Provider Demographics
NPI:1609071380
Name:KWAKO, JAMIE TRUSCOTT (RD)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:TRUSCOTT
Last Name:KWAKO
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:TRUSCOTT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RD
Mailing Address - Street 1:5906 VIA LEMORA
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93117-1806
Mailing Address - Country:US
Mailing Address - Phone:805-964-2003
Mailing Address - Fax:
Practice Address - Street 1:STUDENT HEALTH SERVICE
Practice Address - Street 2:UNIVERSITY OF CALIFORNIA
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93106-7002
Practice Address - Country:US
Practice Address - Phone:805-893-2289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered