Provider Demographics
NPI:1851856777
Name:TRUDELL, KARRIN (RD)
Entity Type:Individual
Prefix:
First Name:KARRIN
Middle Name:
Last Name:TRUDELL
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3328 MEADE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92116-4523
Mailing Address - Country:US
Mailing Address - Phone:858-603-6652
Mailing Address - Fax:
Practice Address - Street 1:3328 MEADE AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92116-4523
Practice Address - Country:US
Practice Address - Phone:858-603-6652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-05
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered