Provider Demographics
NPI:1578830972
Name:BERNARD, TIERZA LYNNE (RD)
Entity Type:Individual
Prefix:MRS
First Name:TIERZA
Middle Name:LYNNE
Last Name:BERNARD
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 ARLINGTON CT
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-5501
Mailing Address - Country:US
Mailing Address - Phone:925-216-5057
Mailing Address - Fax:925-735-0431
Practice Address - Street 1:303 ARLINGTON CT
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-5501
Practice Address - Country:US
Practice Address - Phone:925-216-5057
Practice Address - Fax:925-735-0431
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-30
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA507339133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered