Provider Demographics
NPI:1427797018
Name:BECKWITH, SHARON E (RDN)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:E
Last Name:BECKWITH
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21042 E ARROW HWY APT 40
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91724-1420
Mailing Address - Country:US
Mailing Address - Phone:626-483-7384
Mailing Address - Fax:
Practice Address - Street 1:8876 MISSION BLVD
Practice Address - Street 2:
Practice Address - City:JURUPA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92509-2811
Practice Address - Country:US
Practice Address - Phone:626-483-7384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86062924133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered