Provider Demographics
NPI:1417651779
Name:SALINA NEWTON, SANDRA SUZANNE (RDN NES)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:SUZANNE
Last Name:SALINA NEWTON
Suffix:
Gender:F
Credentials:RDN NES
Other - Prefix:
Other - First Name:RUBY
Other - Middle Name:
Other - Last Name:NEWTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RD
Mailing Address - Street 1:6475 E PACIFIC COAST HWY # 120
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-4201
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6475 E PACIFIC COAST HWY # 120
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90803-4201
Practice Address - Country:US
Practice Address - Phone:562-241-5411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133NN1002X
CA1075058133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education