Provider Demographics
NPI:1598018301
Name:SARCONA TENNER, KATHERINE MARIE (RD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MARIE
Last Name:SARCONA TENNER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:MARIE
Other - Last Name:SARCONA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:2825 J ST
Mailing Address - Street 2:#435
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-4300
Mailing Address - Country:US
Mailing Address - Phone:916-978-0300
Mailing Address - Fax:916-978-0333
Practice Address - Street 1:2825 J ST
Practice Address - Street 2:#435
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-4300
Practice Address - Country:US
Practice Address - Phone:916-978-0300
Practice Address - Fax:916-978-0333
Is Sole Proprietor?:No
Enumeration Date:2012-10-17
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA967548133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered