Provider Demographics
NPI:1649483397
Name:FARRINGTON, SUSAN W (R D)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:W
Last Name:FARRINGTON
Suffix:
Gender:F
Credentials:R D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-4801
Mailing Address - Country:US
Mailing Address - Phone:805-349-8600
Mailing Address - Fax:805-928-5145
Practice Address - Street 1:1401 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-4801
Practice Address - Country:US
Practice Address - Phone:805-349-8600
Practice Address - Fax:805-928-5145
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2014-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education