Provider Demographics
NPI:1972198513
Name:RHODES, EMILY INGALLS (RD, MPH)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:INGALLS
Last Name:RHODES
Suffix:
Gender:F
Credentials:RD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3025 TIFFANY LN
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-9215
Mailing Address - Country:US
Mailing Address - Phone:434-409-0617
Mailing Address - Fax:
Practice Address - Street 1:3025 TIFFANY LN
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-9215
Practice Address - Country:US
Practice Address - Phone:434-409-0617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-05
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86154701133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered