Healthcare Provider Details

I. General information

NPI: 1760844732
Provider Name (Legal Business Name): SARAH JADIN PA-C, RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2016
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2381 ROSECRANS AVE STE 115
EL SEGUNDO CA
90245-4920
US

IV. Provider business mailing address

2381 ROSECRANS AVE STE 115
EL SEGUNDO CA
90245-4920
US

V. Phone/Fax

Practice location:
  • Phone: 920-362-9818
  • Fax: 818-366-4630
Mailing address:
  • Phone: 920-362-9818
  • Fax: 818-366-4630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number966479
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number59616
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: