Healthcare Provider Details

I. General information

NPI: 1740035542
Provider Name (Legal Business Name): TANYA ELLIE ESHEL M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TANYA ELLIE

II. Dates (important events)

Enumeration Date: 04/23/2024
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 15TH ST UNIT 64
DEL MAR CA
92014-8004
US

IV. Provider business mailing address

122 15TH ST UNIT 64
DEL MAR CA
92014-8004
US

V. Phone/Fax

Practice location:
  • Phone: 408-203-9996
  • Fax:
Mailing address:
  • Phone: 408-203-9996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number138920
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: