MEDICARE: KRISTEN RINDRESS RD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133VN1005X	Renal Nutrition Registered Dietitian

General Provider Information

NPI Number	:	1083588792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN RINDRESS RD

Provider Business Mailing Address
First Line	:	6745 E MONLACO RD
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90808-3036
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4223 E ANAHEIM ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90804-4202
Country	:	US
Telephone Number	:	562-725-3224
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2025
Last Update Date	:	10/03/2025

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