Healthcare Provider Details

I. General information

NPI: 1265922199
Provider Name (Legal Business Name): CARLYNN Y SZE MS, RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2018
Last Update Date: 05/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 BROADWAY
OAKLAND CA
94611-5730
US

IV. Provider business mailing address

6363 CHRISTIE AVE APT 2626
EMERYVILLE CA
94608-1979
US

V. Phone/Fax

Practice location:
  • Phone: 510-752-1000
  • Fax:
Mailing address:
  • Phone: 415-299-7894
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code132700000X
TaxonomyDietary Manager
License Number881203
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: