Sonamarivell Granados, RD, LD
Dietitian, Registered in Twin Falls, ID. Individual provider (NPI-1).
NPI number1215420591
StatusActive
Last updated in NPPESJun 11, 2018
Details
- NPI
- 1215420591
- Entity type
- Individual (NPI-1)
- Name
- Sonamarivell Granados
- Credential
- RD, LD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 11, 2018
- Last updated
- Jun 11, 2018
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - REGISTERED DIETITIAN OR NUTRITION PROFESSIONA
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | D-1010 | ID | Yes |
Practice location
801 Pole Line Rd WTwin Falls, ID 83301-5810
Phone 208-814-4120 · Fax 208-814-4906
Mailing address
801 Pole Line Rd WTwin Falls, ID 83301-5810
Phone 208-814-4120 · Fax 208-814-4906
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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