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General NPI Number Information
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NPI Number | 1104518620
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Entity Type | Organization
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Legal Business Name | DIETITIANSHAR CONSULTING SERVICES
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Dates
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Enumeration Date | 05/23/2023
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Last Update Date | 09/06/2025
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Provider Practice Location Address
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Address Line | 453 S SPRING ST STE 400-1255
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City | LOS ANGELES
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State | CA
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Zip | 90013-2013
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Country | US
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Telephone | 213-433-6113
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Fax |
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Provider Business Mailing Address
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Address Line | 453 S SPRING ST STE 400-1255
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City | LOS ANGELES
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State | CA
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Zip | 90013-2013
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Country | US
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Telephone | 213-433-6113
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Fax |
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Authorized Official
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Title or Position | DIETITIAN/OWNER
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Name | SHARVETTE EDMONDS
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Credential | M.S, RD
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Telephone | 213-433-6113
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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