Provider Demographics
NPI:1013428572
Name:ELDRIDGE, KAREN LEIGH (MS, RDN)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:LEIGH
Last Name:ELDRIDGE
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 PROVENCE LN
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-6742
Mailing Address - Country:US
Mailing Address - Phone:916-673-8027
Mailing Address - Fax:
Practice Address - Street 1:307 PROVENCE LN
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-6742
Practice Address - Country:US
Practice Address - Phone:916-673-8027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-23
Last Update Date:2017-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered