Provider Demographics
NPI:1417555632
Name:PALLOTTO, SARAH SWEET (RDN)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:SWEET
Last Name:PALLOTTO
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 1:1892 LAWRENCE RD
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-4838
Mailing Address - Country:US
Mailing Address - Phone:619-862-4705
Mailing Address - Fax:
Practice Address - Street 1:1892 LAWRENCE RD
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-4838
Practice Address - Country:US
Practice Address - Phone:619-862-4705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-09
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI254-LD133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered