Provider Demographics
NPI:1740081827
Name:URBIZTONDO, SHARON (RDN)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:
Last Name:URBIZTONDO
Suffix:
Gender:
Credentials:RDN
Other - Prefix:MISS
Other - First Name:SHARON
Other - Middle Name:
Other - Last Name:SILVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN
Mailing Address - Street 1:411 BRITTANIA CT
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94954-8543
Mailing Address - Country:US
Mailing Address - Phone:707-771-0080
Mailing Address - Fax:
Practice Address - Street 1:1165 MONTGOMERY DR
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405-4801
Practice Address - Country:US
Practice Address - Phone:707-525-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA615481133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered