Organization
R2O NUTRITION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH JACKSON RDN (RDN)
(818) 462-1932
Entity
Organization
Contact information
Practice address
21551 BROOKHURST ST, HUNTINGTON BEACH, CA 92646-8007
(818) 462-1932
(949) 209-2605
Mailing address
21551 BROOKHURST ST APT 41, HUNTINGTON BEACH, CA 92646-8041
(818) 462-1932
Taxonomy
Speciality
Code
Description
License number
State
133VN1201X
Obesity and Weight Management Nutrition Registered Dietitian
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86078203
STATE LICENSE
CA
Enumeration date
12/02/2021
Last updated
12/20/2021
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