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NPI Code Detail

MEDICARE: SARA E FENTON MS RD

MEDICARE: SARA E FENTON MS RD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian920OR

General Provider Information

NPI Number : 1649401274
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARA E FENTON MS RD
Provider Business Mailing Address
First Line : 546 SAUSALITO BLVD
Second Line :
City : SAUSALITO
State : CA
Zip : 94965-2330
Country : US
Telephone Number : 917-439-2503
Fax Number :
Provider Business Practice Location Address
First Line : 546 SAUSALITO BLVD
Second Line :
City : SAUSALITO
State : CA
Zip : 94965-2330
Country : US
Telephone Number : 917-439-2503
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2009
Last Update Date : 05/12/2026

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Directions to “ SARA E FENTON MS RD” Practice Location

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