MRS. JEAN RAE FACCHINI (NPI# 1134397953) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134397953 |
| Entity Type | Individual |
| Full Name | MRS. JEAN RAE FACCHINI |
| Credential | R.D. |
| Practice Address |
2200 Bergquist Dr Ste 1 Attn: Credentials (cmc) Lackland Afb TX 78236-9908 |
| Practice Telephone | 2102927578 |
| Practice Fax Number | 2102927826 |
| Mailing Telephone | 2102927578 |
| Mailing Fax Number | 2102927826 |
| Enumeration Date | 2008-02-14 |
| Last Update Date | 2008-02-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 000002 | GU | Dietary & Nutritional Service Providers |
| Street Address |
2200 BERGQUIST DR STE 1 ATTN: CREDENTIALS (CMC) |
| City | LACKLAND AFB |
| State | TX |
| Zip Code | 78236-9908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427041979 | Terence Gerald Benson Jr. | Pharmacist | 2200 Bergquist Dr Ste 1, Lackland Afb, TX 78236-9908 | 2005-08-30 |
| 1972031011 | George Benson | General Practice | 2200 Bergquist Dr Ste 1, Lackland Afb, TX 78236-9908 | 2017-06-02 |
| 1467984187 | Trevor Edgington | General Practice | 2200 Bergquist Dr Ste 1, Lackland Afb, TX 78236-9908 | 2017-03-31 |
| 1376938399 | Colette Poole-boykin | Student in an Organized Health Care Education/Training Program | 2200 Bergquist Dr Ste 1, Ste 1, Lackland Afb, TX 78236-9908 | 2015-04-06 |
| 1720210933 | John Ryan Brewer | Ophthalmology | 2200 Bergquist Dr Ste 1, Attn: Credentials (cmc), Lackland Afb, TX 78236-9908 | 2009-08-20 |
| 1023256815 | Risa Cavalcanti Riepma | Dietitian, Registered | 2200 Bergquist Dr Ste 1, Attn: Credentials (cmc), Lackland Afb, TX 78236-9908 | 2009-02-02 |
| 1073767117 | Susan Wright Mongeau | Dentist | 2200 Bergquist Dr Ste 1, Lackland Afb, TX 78236-9908 | 2008-11-14 |
| 1053571018 | Brian Michael Fitzgerald | Anesthesiology | 2200 Bergquist Dr Ste 1, Lackland Afb, TX 78236-9908 | 2008-06-12 |
| 1760649297 | Rayna Lane Wooten | Dietitian, Registered | 2200 Bergquist Dr Ste 1, Lackland Afb, TX 78236-9908 | 2008-05-21 |
| 1235309659 | Margaret Bonnie Cole | Pharmacist | 2200 Bergquist Dr Ste 1, Lackland Afb, TX 78236-9908 | 2008-03-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063047363 | Arnoldo Arturo Gonzalez Jr. | Specialist/Technologist | 1033 Truemper St, Lackland Afb, TX 78236 | 2020-03-06 |
| 1023643343 | Meredith Grace Cockerell | Specialist/Technologist | W Military Drive, San Antonio, TX 78236 | 2020-03-06 |
| 1578120598 | Hali Rashelle Hall | Dentist | 1615 Truemper St, Blg 6418, Attn: 59ds/sgdn, Jbsa Lackland, TX 78236 | 2019-05-24 |
| 1952967077 | Paul Fianza Boseman | Nurse Practitioner | 1106 Wilford Hall Loop, San Antonio, TX 78236 | 2019-05-14 |
| 1689161978 | Kelly Jones Buckshire | Dentist | Dunn Dental Clinic, 1615 Truemper Rd, San Antonio, TX 78236 | 2018-04-23 |
| 1902308570 | Roger Louis Farney | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg. 4554, Jbsa Lackland Afb, TX 78236 | 2018-02-28 |
| 1568916856 | Thomas Maxwell Woolf | Dentist | 1100 Wilford Hall Ambulatory Surgical Center, Lackland Afb, TX 78236 | 2016-08-04 |
| 1831544956 | Michael Veronneau | Student in an Organized Health Care Education/Training Program | 59 Mdw/ge 1100 Wilford Hall Loop, Bldg. 4554, Jbsa Lackland, TX 78236 | 2016-04-26 |
| 1376906958 | David Kephart Jr. | General Practice | 1100 Wilford Hall Loop Bldg 4454, Jbsa Lackland, TX 78236 | 2016-04-01 |
| 1184084089 | Olivia Arballo | Dermatology | Wilford Hall Asc, Attn: Dept of Dermatology, 1100 Wilford Hall Loop Bldg 4554, Jbsa-lackland, TX 78236 | 2016-03-04 |
| Find all providers in zip 78236 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679787568 | Sara Burnett | Dietitian, Registered | Whmc 959 Mdts Mtn, 2200 Bergquist Drive, Suite 1, Lackland Afb, TX 78236-9908 | 2007-05-09 |
| 1790772549 | Michael Angeletti | Dietitian, Registered | 2513 Biggs Ave, 37 Amds/sgpz, Lackland Afb, TX 78236 | 2005-10-05 |
| 1508268228 | Abigail Marlow | Dietitian, Registered | 1100 Wilford Hall Loop, Nutritional Medicine, Lackland Afb, TX 78236 | 2014-09-24 |
| 1992016471 | Jennifer Honig | Dietitian, Registered | 1100 Wilford Hall Loop, Lackland Afb, TX 78236-5638 | 2010-06-29 |
| 1023256815 | Risa Cavalcanti Riepma | Dietitian, Registered | 2200 Bergquist Dr Ste 1, Attn: Credentials (cmc), Lackland Afb, TX 78236-9908 | 2009-02-02 |
| 1093953499 | Lindzi Sara Torres | Dietitian, Registered | 1100 Wilford Hall Loop, Lackland Afb, TX 78236 | 2009-01-23 |
| 1760649297 | Rayna Lane Wooten | Dietitian, Registered | 2200 Bergquist Dr Ste 1, Lackland Afb, TX 78236-9908 | 2008-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902637 | Allison Kleppe | Dietitian, Registered | 6255 Oram St Apt 106, Dallas, TX 75214-3985 | 2020-11-08 |
| 1326649088 | Mitzie Rojas | Dietitian, Registered | 1805 Aquarena Springs Dr Apt 505, San Marcos, TX 78666-8164 | 2020-11-07 |
| 1912507971 | Wendy Snowden | Dietitian, Registered | 11223 Kingsgate Dr, Austin, TX 78748-3435 | 2020-10-29 |
| 1720687718 | Jordan Wright | Dietitian, Registered | 2900 N Braeswood Blvd Apt 6204, Houston, TX 77025-2367 | 2020-10-20 |
| 1891393062 | Melanie Thomas | Dietitian, Registered | 4722 Pickridge Ct, Fresno, TX 77545-7529 | 2020-10-11 |
| 1073110318 | Mary Elizabeth Santarosa Mahoney | Dietitian, Registered | 1322 Cotulla Dr, Allen, TX 75013-4639 | 2020-10-08 |
| 1104423797 | Mariam Maaz Eid | Dietitian, Registered | 8421 Etienne Cv, Austin, TX 78759-8201 | 2020-10-06 |
| 1518564467 | Elizabeth Hill | Dietitian, Registered | 6500 Champion Grandview Way Apt 22105, Austin, TX 78750-8388 | 2020-10-05 |
| 1215534441 | Maryia Nassonova | Dietitian, Registered | 5740 Airport Fwy, Haltom City, TX 76117-6005 | 2020-10-01 |
| 1366049488 | Ifunanya Onyima | Dietitian, Registered | 2500 Marketplace Dr Apt 536, Waco, TX 76711-2440 | 2020-10-01 |
| Find all providers with the same taxonomy | ||||
| City | LACKLAND AFB |
| Zip Code | 78236 |
Please comment or provide details below to improve the information on MRS. JEAN RAE FACCHINI.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.