MEDICARE: DR. SHEILA VISWANATHAN R.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	1038563	NY

General Provider Information

NPI Number	:	1508242686
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHEILA VISWANATHAN R.D.

Provider Business Mailing Address
First Line	:	438 W GRAND AVE
Second Line	:	UNIT 628
City	:	OAKLAND
State	:	CA
Zip	:	94612-2337
Country	:	US
Telephone Number	:	201-414-2850
Fax Number	:

Provider Business Practice Location Address
First Line	:	438 W GRAND AVE
Second Line	:	UNIT 628
City	:	OAKLAND
State	:	CA
Zip	:	94612-2337
Country	:	US
Telephone Number	:	201-414-2850
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/30/2015
Last Update Date	:	07/30/2015

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Directions to “ DR. SHEILA VISWANATHAN R.D.” Practice Location

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