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Individual

ELIZABETH WYTYCHAK DODS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
6121 HOLLIS ST STE 400, EMERYVILLE, CA 94608-2077
(510) 266-5401
Mailing address
6121 HOLLIS ST STE 400, EMERYVILLE, CA 94608-2077
(510) 266-5401

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
98811
CT
363L00000X
Nurse Practitioner
Primary
95031987
CA
363L00000X
Nurse Practitioner
AP60411118
WA
363LF0000X
Family Nurse Practitioner
005605
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004236346
CT
Enumeration date
07/27/2012
Last updated
09/11/2025
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