Healthcare Provider Details
I. General information
NPI: 1750265492
Provider Name (Legal Business Name): ALEXANDRA EISELE RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/05/2025
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
914 N COAST HIGHWAY 101 STE A
ENCINITAS CA
92024-2074
US
IV. Provider business mailing address
1384 HYGEIA AVE
ENCINITAS CA
92024-1621
US
V. Phone/Fax
- Phone: 202-932-9958
- Fax:
- Phone: 760-631-5000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 133V00000X |
| Taxonomy | Registered Dietitian |
| License Number | 86168684 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: