Provider Demographics
NPI:1376172288
Name:SHERWIN, JANET L (RDN)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:L
Last Name:SHERWIN
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 STONEGATE CIR
Mailing Address - Street 2:
Mailing Address - City:OAKLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94561-3060
Mailing Address - Country:US
Mailing Address - Phone:510-703-5705
Mailing Address - Fax:
Practice Address - Street 1:920 STONEGATE CIR
Practice Address - Street 2:
Practice Address - City:OAKLEY
Practice Address - State:CA
Practice Address - Zip Code:94561-3060
Practice Address - Country:US
Practice Address - Phone:510-703-5705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-02
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86075935133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered