Provider Demographics
NPI:1588445936
Name:RAYMOND, ALEXANDRA (RD, LD/N)
Entity type:Individual
Prefix:MISS
First Name:ALEXANDRA
Middle Name:
Last Name:RAYMOND
Suffix:
Gender:F
Credentials:RD, LD/N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11227 CONSTELLATION DR
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-8213
Mailing Address - Country:US
Mailing Address - Phone:619-974-9420
Mailing Address - Fax:
Practice Address - Street 1:11227 CONSTELLATION DR
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-8213
Practice Address - Country:US
Practice Address - Phone:619-974-9420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
871788133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered