Provider Demographics
NPI:1578135646
Name:EATON, REBEKAH LYNNE (RDN)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:LYNNE
Last Name:EATON
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:REBEKAH
Other - Middle Name:LYNNE
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RDN
Mailing Address - Street 1:2235 NATOMAS PARK DR UNIT 6104
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95833-2993
Mailing Address - Country:US
Mailing Address - Phone:916-712-1707
Mailing Address - Fax:
Practice Address - Street 1:3450 INDUSTRIAL BLVD STE 100
Practice Address - Street 2:
Practice Address - City:WEST SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95691-5053
Practice Address - Country:US
Practice Address - Phone:916-371-4947
Practice Address - Fax:916-371-8845
Is Sole Proprietor?:No
Enumeration Date:2021-07-16
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal
Provider Identifiers
StateIdentifier IDID TypeIssuer
86013571OtherCDR REGISTRATION ID NUMBER