=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518721810
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHARON CHARLES RD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/08/2024
-----------------------------------------------------
Last Update Date | 05/11/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 29377 RANCHO CALIFORNIA RD STE 103
-----------------------------------------------------
City | TEMECULA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92591-5206
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-387-5201
-----------------------------------------------------
Fax | 866-502-2851
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1035 LA TERRAZA CIR UNIT 205
-----------------------------------------------------
City | CORONA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92879-7800
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-387-5201
-----------------------------------------------------
Fax | 866-502-2851
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 133V00000X
-----------------------------------------------------
Taxonomy Name | Registered Dietitian
-----------------------------------------------------
License Number | 86371326
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------