Provider Demographics
NPI:1295378552
Name:CHARTON, SARAH (RD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:CHARTON
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 LOS PUEBLOS DR
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-5321
Mailing Address - Country:US
Mailing Address - Phone:805-914-4769
Mailing Address - Fax:
Practice Address - Street 1:21515 HAWTHORNE BLVD
Practice Address - Street 2:
Practice Address - City:LOS TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-2480
Practice Address - Country:US
Practice Address - Phone:323-746-8856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-18
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86052972133VN1501X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1501XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Sports Dietetics