Provider Demographics
NPI:1235385550
Name:SZAREK, BRITTANY LEEANN (RD, CSP, LD, CHC)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:LEEANN
Last Name:SZAREK
Suffix:
Gender:F
Credentials:RD, CSP, LD, CHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 SAN PABLO AVE
Mailing Address - Street 2:#319
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-4199
Mailing Address - Country:US
Mailing Address - Phone:319-423-9355
Mailing Address - Fax:
Practice Address - Street 1:33 SAN PABLO AVE
Practice Address - Street 2:#319
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-4199
Practice Address - Country:US
Practice Address - Phone:319-423-9355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-18
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT80739133V00000X
133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDT80739OtherLICENSED DIETITIAN
926414OtherREGISTERED DIETITIAN