Provider Demographics
NPI:1215624440
Name:FERRER NGUYEN, EILEEN MOLINA (RDN)
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:MOLINA
Last Name:FERRER NGUYEN
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:EILEEN
Other - Middle Name:MOLINA
Other - Last Name:FERRER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN
Mailing Address - Street 1:4065 COUNTY CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-3410
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4065 COUNTY CIRCLE DR
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3410
Practice Address - Country:US
Practice Address - Phone:951-470-9907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86017644133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered