Provider Demographics
NPI:1265124960
Name:ADAMS, ALEXIS (RD)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:ADAMS
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 1:417 SALISBURY LN
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-1936
Mailing Address - Country:US
Mailing Address - Phone:909-731-7928
Mailing Address - Fax:
Practice Address - Street 1:417 SALISBURY LN
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-1936
Practice Address - Country:US
Practice Address - Phone:909-731-7928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered