Provider Demographics
NPI:1427665785
Name:BYERS, ELISABETH E (RDN)
Entity type:Individual
Prefix:
First Name:ELISABETH
Middle Name:E
Last Name:BYERS
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 MOWRY AVE
Mailing Address - Street 2:PMB 24
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536
Mailing Address - Country:US
Mailing Address - Phone:510-565-4696
Mailing Address - Fax:
Practice Address - Street 1:405 RANCHO ARROYO PKWY APT 360
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-2751
Practice Address - Country:US
Practice Address - Phone:510-565-4696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered