Healthcare Provider Details

I. General information

NPI: 1477151637
Provider Name (Legal Business Name): SHARON J BOWERS RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHARON J HOSKINS RD

II. Dates (important events)

Enumeration Date: 10/10/2020
Last Update Date: 06/19/2024
Certification Date: 06/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 COMMERCE AVE STE E
PALMDALE CA
93551-3882
US

IV. Provider business mailing address

602 COMMERCE AVE STE E
PALMDALE CA
93551-3882
US

V. Phone/Fax

Practice location:
  • Phone: 661-213-9126
  • Fax: 877-847-0590
Mailing address:
  • Phone: 661-213-9126
  • Fax: 877-847-0590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code133VN1201X
TaxonomyObesity and Weight Management Nutrition Registered Dietitian
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code133VN1301X
TaxonomyOncology Nutrition Registered Dietitian
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: