Provider Demographics
NPI:1285526186
Name:SMITH, SABRINA MARIE (RD)
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:MARIE
Last Name:SMITH
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 MYSTIC RIVER RD
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-3518
Mailing Address - Country:US
Mailing Address - Phone:619-318-3403
Mailing Address - Fax:
Practice Address - Street 1:425 CALIFORNIA ST STE 1400
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94104-2116
Practice Address - Country:US
Practice Address - Phone:212-589-2700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-16
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALDN8270133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered