Provider Demographics
NPI:1609645936
Name:SHELDON, SHARA (MS PHD RDN)
Entity Type:Individual
Prefix:
First Name:SHARA
Middle Name:
Last Name:SHELDON
Suffix:
Gender:F
Credentials:MS PHD RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 TUFTS PL
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695-5077
Mailing Address - Country:US
Mailing Address - Phone:916-580-7313
Mailing Address - Fax:
Practice Address - Street 1:925 TUFTS PL
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-5077
Practice Address - Country:US
Practice Address - Phone:916-580-7313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-28
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86302366133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered