Provider Demographics
NPI:1992328207
Name:DEL RIO, ELIZABETH (MS, RDN, LD)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:
Last Name:DEL RIO
Suffix:
Gender:F
Credentials:MS, RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3390 OCTAVIUS DR APT 233
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95054-3151
Mailing Address - Country:US
Mailing Address - Phone:832-607-8209
Mailing Address - Fax:
Practice Address - Street 1:120 SAN LUCAR CT
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94086-5213
Practice Address - Country:US
Practice Address - Phone:855-816-7705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-20
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86086637133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty