Provider Demographics
NPI:1720594328
Name:SABEDRA, EMILY
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:SABEDRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5310 BRADFORD DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95820-6721
Mailing Address - Country:US
Mailing Address - Phone:707-599-0541
Mailing Address - Fax:
Practice Address - Street 1:5960 S LAND PARK DR # 950
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95822-3313
Practice Address - Country:US
Practice Address - Phone:707-599-0541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-18
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86265249133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered