Suzanne Mary Kordesh, RD
Dietitian, Registered in Oakland, CA. Individual provider (NPI-1).
NPI number1821149006
StatusActive
Last updated in NPPESJan 3, 2022
Details
- NPI
- 1821149006
- Entity type
- Individual (NPI-1)
- Name
- Ms. Suzanne Mary Kordesh
- Credential
- RD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 15, 2007
- Last updated
- Jan 3, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | 687616 | CA | Yes |
Practice location
280 W Macarthur BlvdOakland, CA 94611-5642
Phone 510-752-1386
Mailing address
3505 Broadway7th Floor
Oakland, CA 94611-5714
Phone 510-752-1386
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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