Healthcare Provider Details

I. General information

NPI: 1649483397
Provider Name (Legal Business Name): SUSAN W FARRINGTON R. D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 04/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 E MAIN ST
SANTA MARIA CA
93454-4801
US

IV. Provider business mailing address

1401 E MAIN ST
SANTA MARIA CA
93454-4801
US

V. Phone/Fax

Practice location:
  • Phone: 805-349-8600
  • Fax: 805-928-5145
Mailing address:
  • Phone: 805-349-8600
  • Fax: 805-928-5145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: