Provider Demographics
NPI:1851043491
Name:STERLING, WENDY
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:STERLING
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 1:1017 EL CAMINO REAL # 234
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-1691
Mailing Address - Country:US
Mailing Address - Phone:917-566-9695
Mailing Address - Fax:866-345-2420
Practice Address - Street 1:1017 EL CAMINO REAL # 234
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-1691
Practice Address - Country:US
Practice Address - Phone:917-566-9695
Practice Address - Fax:866-345-2420
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-25
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
CA859803133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1851043491OtherDIETITIAN
1851043491OtherNA