Provider Demographics
NPI:1679218952
Name:CROSTHWAITE, SARAH MICHELLE
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MICHELLE
Last Name:CROSTHWAITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1928 THIBODO RD UNIT 23-203
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92081-7924
Mailing Address - Country:US
Mailing Address - Phone:760-685-5259
Mailing Address - Fax:
Practice Address - Street 1:2185 CITRACADO PKWY
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92029-4159
Practice Address - Country:US
Practice Address - Phone:442-281-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-02
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered