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NPI Code Detail

MEDICARE: REBEKAH LYNNE EATON RDN

MEDICARE:   REBEKAH LYNNE EATON  RDN
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
1133VN1005XRenal Nutrition Registered Dietitian
2133V00000XRegistered Dietitian

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
186013571OTHERCDR REGISTRATION ID NUMBER

General Provider Information

NPI Number : 1578135646
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBEKAH LYNNE EATON RDN
Provider Business Mailing Address
First Line : 2235 NATOMAS PARK DR UNIT 6104
Second Line :
City : SACRAMENTO
State : CA
Zip : 95833-2993
Country : US
Telephone Number : 916-712-1707
Fax Number :
Provider Business Practice Location Address
First Line : 3450 INDUSTRIAL BLVD STE 100
Second Line :
City : WEST SACRAMENTO
State : CA
Zip : 95691-5053
Country : US
Telephone Number : 916-371-4947
Fax Number : 916-371-8845
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2021
Last Update Date : 01/11/2022

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