MEDICARE: EMILY SABEDRA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	86265249	CA

General Provider Information

NPI Number	:	1720594328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY SABEDRA

Provider Business Mailing Address
First Line	:	5310 BRADFORD DR
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95820-6721
Country	:	US
Telephone Number	:	707-599-0541
Fax Number	:

Provider Business Practice Location Address
First Line	:	5960 S LAND PARK DR # 950
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95822-3313
Country	:	US
Telephone Number	:	707-599-0541
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2017
Last Update Date	:	08/02/2024

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