Provider Demographics
NPI:1821567454
Name:CAPPS, ELIZABETH (RDN)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:CAPPS
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 N LONDONDERRY LN UNIT A
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92869-2859
Mailing Address - Country:US
Mailing Address - Phone:714-496-6220
Mailing Address - Fax:
Practice Address - Street 1:470 N LONDONDERRY LN UNIT A
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92869-2859
Practice Address - Country:US
Practice Address - Phone:714-496-6220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-13
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86102892133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered