Provider Demographics
NPI:1053298034
Name:RICHENDOLLAR, STEVEN (RDN)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:RICHENDOLLAR
Suffix:
Gender:M
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5965 BENT PINE DR APT 2123
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-6603
Mailing Address - Country:US
Mailing Address - Phone:440-897-1689
Mailing Address - Fax:
Practice Address - Street 1:425 CALIFORNIA ST STE 1400
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94104-2116
Practice Address - Country:US
Practice Address - Phone:212-589-2700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL86132903133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered