Healthcare Provider Details

I. General information

NPI: 1952776791
Provider Name (Legal Business Name): CHHAYA B PATEL MS, RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2015
Last Update Date: 12/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2905 TELEGRAPH AVE
BERKELEY CA
94705-2017
US

IV. Provider business mailing address

2905 TELEGRAPH AVE
BERKELEY CA
94705-2017
US

V. Phone/Fax

Practice location:
  • Phone: 510-841-0411
  • Fax: 510-204-9086
Mailing address:
  • Phone: 510-841-0411
  • Fax: 510-204-9086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License Number589250
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: