Provider Demographics
NPI:1477275873
Name:RESCH, ELYSE R (MS, RDN, CEDS-S)
Entity Type:Individual
Prefix:MS
First Name:ELYSE
Middle Name:R
Last Name:RESCH
Suffix:
Gender:F
Credentials:MS, RDN, CEDS-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 LINDA LN
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-5810
Mailing Address - Country:US
Mailing Address - Phone:310-713-8802
Mailing Address - Fax:310-396-4064
Practice Address - Street 1:3001 LINDA LN
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90405-5810
Practice Address - Country:US
Practice Address - Phone:310-995-8802
Practice Address - Fax:310-396-4064
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered