Provider Demographics
NPI:1922460294
Name:ORBETA, LINDSAY MARIE (MS, RD, CSSD)
Entity Type:Individual
Prefix:MISS
First Name:LINDSAY
Middle Name:MARIE
Last Name:ORBETA
Suffix:
Gender:F
Credentials:MS, RD, CSSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 13TH ST
Mailing Address - Street 2:SUITE 304
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-3954
Mailing Address - Country:US
Mailing Address - Phone:415-678-6093
Mailing Address - Fax:
Practice Address - Street 1:330 13TH ST
Practice Address - Street 2:SUITE 304
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-3954
Practice Address - Country:US
Practice Address - Phone:415-678-6093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-24
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA967832133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered