Provider Demographics
NPI:1497055719
Name:LEARD, SHEILA (RD)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:LEARD
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 1:5145 GOLDEN FOOTHILL PKWY 190
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-9655
Mailing Address - Country:US
Mailing Address - Phone:916-730-9118
Mailing Address - Fax:
Practice Address - Street 1:5145 GOLDEN FOOTHILL PKWY
Practice Address - Street 2:SUITE 190
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-9640
Practice Address - Country:US
Practice Address - Phone:916-730-9118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-03
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA681382133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered