Provider Demographics
NPI:1215274279
Name:SHELTON, LINDA JANE (RD)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:JANE
Last Name:SHELTON
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 1:121 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-5450
Mailing Address - Country:US
Mailing Address - Phone:559-297-6990
Mailing Address - Fax:
Practice Address - Street 1:1920 MARIPOSA MALL STE 120
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93721-2504
Practice Address - Country:US
Practice Address - Phone:559-263-1158
Practice Address - Fax:559-263-1152
Is Sole Proprietor?:No
Enumeration Date:2013-01-10
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered