Provider Demographics
NPI:1841804259
Name:GEELS, ELENA (RD, CDE)
Entity Type:Individual
Prefix:
First Name:ELENA
Middle Name:
Last Name:GEELS
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:
Other - First Name:ELENA
Other - Middle Name:
Other - Last Name:BURBRIDGE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4121 HARBOR VIEW AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94619-2207
Mailing Address - Country:US
Mailing Address - Phone:415-990-6586
Mailing Address - Fax:
Practice Address - Street 1:1100 VAN NESS AVE FL 4
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-6978
Practice Address - Country:US
Practice Address - Phone:415-600-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-02
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1080718133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered