Provider Demographics
NPI:1396807236
Name:JURECKI, ELAINA RYDER (MS, RD)
Entity type:Individual
Prefix:MS
First Name:ELAINA
Middle Name:RYDER
Last Name:JURECKI
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9565 BROADMOOR DR
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-3819
Mailing Address - Country:US
Mailing Address - Phone:925-829-4006
Mailing Address - Fax:925-829-4006
Practice Address - Street 1:280 W MACARTHUR BLVD
Practice Address - Street 2:GENETICS DEPARTMENT
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-5642
Practice Address - Country:US
Practice Address - Phone:510-752-1388
Practice Address - Fax:510-752-6367
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic