Provider Demographics
NPI:1659595338
Name:DOOLITTLE, ERICKA SUZANNE (RD, MPH)
Entity Type:Individual
Prefix:
First Name:ERICKA
Middle Name:SUZANNE
Last Name:DOOLITTLE
Suffix:
Gender:F
Credentials:RD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2122 LAKESHORE AVE APT 602
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94606-1110
Mailing Address - Country:US
Mailing Address - Phone:510-499-1086
Mailing Address - Fax:
Practice Address - Street 1:2122 LAKESHORE AVE APT 602
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94606-1110
Practice Address - Country:US
Practice Address - Phone:510-499-1086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered