Provider Demographics
NPI:1407973944
Name:SHON, CHARLENE SAITO (RD)
Entity Type:Individual
Prefix:MS
First Name:CHARLENE
Middle Name:SAITO
Last Name:SHON
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 1:353 SANDPIPER DR
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-7539
Mailing Address - Country:US
Mailing Address - Phone:530-758-6768
Mailing Address - Fax:530-758-7658
Practice Address - Street 1:137 N. COTTONWOOD ST. SUITE 1200
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695
Practice Address - Country:US
Practice Address - Phone:530-666-8447
Practice Address - Fax:530-666-6273
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered