Provider Demographics
NPI:1902259781
Name:COLIN, AYDE (RD/RDN)
Entity Type:Individual
Prefix:
First Name:AYDE
Middle Name:
Last Name:COLIN
Suffix:
Gender:F
Credentials:RD/RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 LAWRENCE EXPRESSWAY
Mailing Address - Street 2:HEALTH EDUCATION DEPARTMENT #182
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051
Mailing Address - Country:US
Mailing Address - Phone:408-851-3800
Mailing Address - Fax:
Practice Address - Street 1:710 LAWRENCE EXPRESSWAY
Practice Address - Street 2:HEALTH EDUCATION DEPARTMENT #182
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051
Practice Address - Country:US
Practice Address - Phone:408-851-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-18
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86050360132700000X, 133N00000X, 133NN1002X, 133VN1004X, 133VN1005X, 133VN1006X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No132700000XDietary & Nutritional Service ProvidersDietary Manager
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric
No133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic