Provider Demographics
NPI:1922253376
Name:KOLBE, PATRICIA E (RD)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:E
Last Name:KOLBE
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 1:620 BRIGHTON RD
Mailing Address - Street 2:
Mailing Address - City:PACIFICA
Mailing Address - State:CA
Mailing Address - Zip Code:94044-2816
Mailing Address - Country:US
Mailing Address - Phone:650-359-3374
Mailing Address - Fax:
Practice Address - Street 1:620 BRIGHTON RD
Practice Address - Street 2:
Practice Address - City:PACIFICA
Practice Address - State:CA
Practice Address - Zip Code:94044-2816
Practice Address - Country:US
Practice Address - Phone:650-359-3374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-26
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL587145133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered