Healthcare Provider Details

I. General information

NPI: 1063369858
Provider Name (Legal Business Name): SARAH ELIZABETH CAMPBELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2026
Last Update Date: 07/18/2026
Certification Date: 07/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3544 SHADY GLEN LN
SACRAMENTO CA
95834-4083
US

IV. Provider business mailing address

3544 SHADY GLEN LN
SACRAMENTO CA
95834-4083
US

V. Phone/Fax

Practice location:
  • Phone: 702-483-0734
  • Fax:
Mailing address:
  • Phone: 702-483-0734
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: