Provider Demographics
NPI:1750440160
Name:STEPHENS, RHONDA LYNN (RD)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:LYNN
Last Name:STEPHENS
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 1:200 MUIR RD
Mailing Address - Street 2:MEDICINE G, E-3516
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-4614
Mailing Address - Country:US
Mailing Address - Phone:925-372-1567
Mailing Address - Fax:925-372-1872
Practice Address - Street 1:200 MUIR RD
Practice Address - Street 2:MEDICINE G, E-3516
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-4614
Practice Address - Country:US
Practice Address - Phone:925-372-1567
Practice Address - Fax:925-372-1872
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA723113133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered