Provider Demographics
NPI:1265271555
Name:SHARON ONA FUNCTIONAL NUTRITION LLC
Entity type:Organization
Organization Name:SHARON ONA FUNCTIONAL NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:ONA
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CN, LD
Authorized Official - Phone:971-206-4163
Mailing Address - Street 1:8605 SANTA MONICA BLVD # 609821
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90069-4109
Mailing Address - Country:US
Mailing Address - Phone:971-206-4163
Mailing Address - Fax:855-274-8188
Practice Address - Street 1:29625 CANWOOD ST
Practice Address - Street 2:
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-4213
Practice Address - Country:US
Practice Address - Phone:971-206-4163
Practice Address - Fax:855-274-8188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-24
Last Update Date:2024-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty