Individual
LAURA RUTH DISHAROON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD
Contact information
Practice address
222 WELLER ST STE 4, PETALUMA, CA 94952-7106
(415) 370-1654
Mailing address
222 WELLER ST STE 4, PETALUMA, CA 94952-7106
(415) 370-1654
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
990826
CA
Other
Enumeration date
12/17/2008
Last updated
01/03/2022
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