Individual
TARA ROTHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LDN, CN, CNS
Contact information
Practice address
3124 INTERNATIONAL BLVD, OAKLAND, CA 94601-2902
(510) 434-5421
Mailing address
6812 WILTON DR, OAKLAND, CA 94611-1707
(630) 674-8002
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
DX5343
MD
Other
Enumeration date
09/16/2021
Last updated
11/08/2021
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