Provider Demographics
NPI:1508526658
Name:KRUGER, RACHEL WIRTHLIN (MPH, RDN)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:WIRTHLIN
Last Name:KRUGER
Suffix:
Gender:F
Credentials:MPH, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 FREMONT AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94024-6045
Mailing Address - Country:US
Mailing Address - Phone:801-882-4390
Mailing Address - Fax:
Practice Address - Street 1:100 N WHISMAN RD APT 3411
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94043-4973
Practice Address - Country:US
Practice Address - Phone:801-882-4390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-29
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA086067282133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered