Healthcare Provider Details

I. General information

NPI: 1326597543
Provider Name (Legal Business Name): VANESSA KOBZA MS, RD, CSP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2016
Last Update Date: 11/27/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 52ND ST RM 3A109
OAKLAND CA
94609
US

IV. Provider business mailing address

747 52ND ST RM 3A109
OAKLAND CA
94609-1809
US

V. Phone/Fax

Practice location:
  • Phone: 510-428-3885
  • Fax:
Mailing address:
  • Phone: 510-428-3885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: