Provider Demographics
NPI:1811348584
Name:STURM, PAULA MARIE (RD)
Entity type:Individual
Prefix:MS
First Name:PAULA
Middle Name:MARIE
Last Name:STURM
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10344 CRAFTSMAN WAY
Mailing Address - Street 2:303
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-3540
Mailing Address - Country:US
Mailing Address - Phone:858-525-2054
Mailing Address - Fax:
Practice Address - Street 1:10344 CRAFTSMAN WAY
Practice Address - Street 2:303
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-3540
Practice Address - Country:US
Practice Address - Phone:858-525-2054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-23
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA981392133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered