Provider Demographics
NPI:1679105514
Name:BRIORI, EVELYN (RD)
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:
Last Name:BRIORI
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 1:1080 JONES ST APT 530
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94710-1564
Mailing Address - Country:US
Mailing Address - Phone:832-257-5524
Mailing Address - Fax:
Practice Address - Street 1:1080 JONES ST APT 530
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94710-1564
Practice Address - Country:US
Practice Address - Phone:832-257-5524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-09
Last Update Date:2024-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86169937133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty