Healthcare Provider Details

I. General information

NPI: 1154838530
Provider Name (Legal Business Name): SARAH MAE VOLLING MS, RD, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2018
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 S BUENA VISTA ST STE 410
BURBANK CA
91505-4571
US

IV. Provider business mailing address

7407 CONNER LN
EDWARDSVILLE IL
62025-4669
US

V. Phone/Fax

Practice location:
  • Phone: 818-253-9727
  • Fax:
Mailing address:
  • Phone: 913-314-0145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number164.007078
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1086982
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2017004357
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: