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General NPI Number Information
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NPI Number | 1295378552
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Entity Type | Individual
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Provider Name | SARAH CHARTON RD
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Gender | Female
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Dates
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Enumeration Date | 10/18/2019
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Last Update Date | 06/08/2023
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Provider Practice Location Address
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Address Line | 21515 HAWTHORNE BLVD
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City | LOS TORRANCE
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State | CA
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Zip | 90503-2480
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Country | US
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Telephone | 323-746-8856
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Fax |
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Provider Business Mailing Address
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Address Line | 707 LOS PUEBLOS DR
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City | CAMARILLO
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State | CA
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Zip | 93012-5321
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Country | US
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Telephone | 805-914-4769
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133VN1501X
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Taxonomy Name | Sports Dietetics Nutrition Registered Dietitian
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License Number | 86052972
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License Number State | CA
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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 | 86052972
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License Number State | CA
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