Provider Demographics
NPI:1861031817
Name:SCHLAG, KATE ALEXA (RD)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:ALEXA
Last Name:SCHLAG
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 1:5867 OCEAN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-1534
Mailing Address - Country:US
Mailing Address - Phone:303-204-2316
Mailing Address - Fax:
Practice Address - Street 1:5867 OCEAN VIEW DR
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-1534
Practice Address - Country:US
Practice Address - Phone:303-204-2316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-21
Last Update Date:2019-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8601852133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered