Provider Demographics
NPI:1013436146
Name:SASSOWER, BARBRA ANN (RDN)
Entity type:Individual
Prefix:
First Name:BARBRA
Middle Name:ANN
Last Name:SASSOWER
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 1:301 N PALM CANYON DR STE 103-1045
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-5672
Mailing Address - Country:US
Mailing Address - Phone:909-228-9899
Mailing Address - Fax:
Practice Address - Street 1:39000 BOB HOPE DR
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-3221
Practice Address - Country:US
Practice Address - Phone:909-228-9989
Practice Address - Fax:909-228-9989
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-09
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA819555133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered