Provider Demographics
NPI:1104518620
Name:DIETITIANSHAR CONSULTING SERVICES
Entity type:Organization
Organization Name:DIETITIANSHAR CONSULTING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIETITIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARVETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:EDMONDS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD
Authorized Official - Phone:213-433-6113
Mailing Address - Street 1:453 S SPRING ST STE 400-1255
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90013-2013
Mailing Address - Country:US
Mailing Address - Phone:213-433-6113
Mailing Address - Fax:
Practice Address - Street 1:453 S SPRING ST STE 400-1255
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90013-2013
Practice Address - Country:US
Practice Address - Phone:213-433-6113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-23
Last Update Date:2025-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty