LISA DE FAZIO (NPI# 1154597623) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154597623 |
| Entity Type | Individual |
| Full Name | LISA DE FAZIO |
| Other Name | LISA DE FAZIO-GAMITYAN |
| Credential | R.D. |
| Practice Address |
415 Rolling Oaks Dr Suite 210 Thousand Oaks CA 91361-1029 |
| Practice Telephone | 8052990301 |
| Mailing Telephone | 8052990301 |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2009-06-26 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 859439 | CA | Dietary & Nutritional Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DIETETIC REGISTRATION | 859439 | 01 |
| Street Address |
415 ROLLING OAKS DR SUITE 210 |
| City | THOUSAND OAKS |
| State | CA |
| Zip Code | 91361-1029 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881665586 | Glenn Eric Waldman | Specialist | 415 Rolling Oaks Dr, Suite 190, Thousand Oaks, CA 91361-1029 | 2006-01-30 |
| 1588198790 | Kiavash Nikkhou Md Inc | Urology | 415 Rolling Oaks Dr, Suite 260, Thousand Oaks, CA 91361-1029 | 2017-04-13 |
| 1598216020 | Edge Medical Services | Clinic/Center | 415 Rolling Oaks Dr, 191, Thousand Oaks, CA 91361-1029 | 2016-10-19 |
| 1366992828 | Edge Medical Services | Clinic/Center | 415 Rolling Oaks Dr, 190, Thousand Oaks, CA 91361-1029 | 2016-10-09 |
| 1114396298 | Push Midwifery | Midwife | 415 Rolling Oaks Dr, Suite 190, Thousand Oaks, CA 91361-1029 | 2015-09-18 |
| 1740681014 | Victoria Lauren Hofius | Physical Therapist | 415 Rolling Oaks Dr, Thousand Oaks, CA 91361-1029 | 2014-09-05 |
| 1003216276 | Rolling Oaks Surgery Center LLC | Clinic/Center | 415 Rolling Oaks Dr, Suite 115, Thousand Oaks, CA 91361-1029 | 2014-08-25 |
| 1477780229 | Aviisha Medical Corporation | Dietitian, Registered | 415 Rolling Oaks Dr, Suite 210, Thousand Oaks, CA 91361-1029 | 2009-06-19 |
| 1033312079 | Farideh Kohanghadosh | Dentist | 415 Rolling Oaks Dr, Suite 120, Thousand Oaks, CA 91361-1029 | 2007-06-07 |
| 1649471061 | Southern California Advanced Laparo Endoscopic Surgery | Surgery | 415 Rolling Oaks Dr, Suite 240, Thousand Oaks, CA 91361-1029 | 2007-05-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093328379 | Lauren Kaprielian Davidson | Speech-Language Pathologist | Fox Therapy Services, 31822 Village Center Rd, Ste. 107, Westlake Village, CA 91361 | 2020-08-26 |
| 1679118749 | Min A Baek | Optometrist | 4353 Park Terrace Dr., #150, Westlake Village, CA 91361 | 2019-11-13 |
| 1417429952 | Kimberly Joanne Yudt | Behavioral Analyst | 660 Hampshire Road, Suite 100, Westlake Village, CA 91361 | 2018-12-21 |
| 1932671773 | Rachel Sonya Chistyakov | Marriage & Family Therapist | 32107 Undero Canyon Rd, Suite 203, Westlake Village, CA 91361 | 2018-12-18 |
| 1447778394 | Spirit Healthcare Hospice, Inc. | Hospice Care, Community Based | 30941 Agoura Rd., Suite 112, Westlake Village, CA 91361 | 2017-08-30 |
| 1023556313 | Lindsay Gooze | Marriage & Family Therapist | 38122 Village Center Rd., Ste.102, Westlake Village, CA 91361 | 2017-02-07 |
| 1851839419 | Casey J. Simon | Counselor | 1800 Bridgegate Street, Suite #108, Westlake Village, CA 91361 | 2017-02-03 |
| 1689124851 | David Schwartz | Marriage & Family Therapist | 30961 Agoura Rd Ste 215, Westlake Village, CA 91361 | 2016-10-11 |
| 1932655735 | Sherry Safavi | Counselor | 677 Colorado Blivd, Los Angeles, CA 91361 | 2016-08-31 |
| 1053795393 | Kashmir Trading Inc. | Durable Medical Equipment & Medical Supplies | 790 Hampshire Rd. Ste #b, Westlake Village, CA 91361 | 2015-07-16 |
| Find all providers in zip 91361 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306311493 | Nicolle Marie Warner | Dietitian, Registered | 55 Rolling Oaks Dr Ste 100, Thousand Oaks, CA 91361-1010 | 2018-10-04 |
| 1427476530 | Marissa Podell | Dietitian, Registered | 1242 El Monte Dr, Thousand Oaks, CA 91362-2119 | 2014-04-04 |
| 1316173669 | Stuart Nathan Reznick | Dietitian, Registered | 1955 Shady Brook Dr, Thousand Oaks, CA 91362-1337 | 2009-06-01 |
| 1346496536 | Lori Ann Robinson | Dietitian, Registered | 4246 Avenida Prado, Thousand Oaks, CA 91360-6837 | 2008-08-07 |
| 1174542237 | Jennifer Harvey Benson | Dietitian, Registered | 329 S Moorpark Rd, Thousand Oaks, CA 91361-1008 | 2006-07-19 |
| 1629533401 | Lindsay Mae Frieder | Dietitian, Registered | 227 W Janss Rd Ste 300, Thousand Oaks, CA 91360-1885 | 2019-02-05 |
| 1477780229 | Aviisha Medical Corporation | Dietitian, Registered | 415 Rolling Oaks Dr, Suite 210, Thousand Oaks, CA 91361-1029 | 2009-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760083448 | Fuad Al Qudsi | Dietitian, Registered | 25874 Carmel Knolls Dr, Carmel, CA 93923-8830 | 2020-11-08 |
| 1700487535 | Katherine Zanville | Dietitian, Registered | 4928 Bellaire Ave, Valley Village, CA 91607-3419 | 2020-11-06 |
| 1760083711 | Gabriela E Zeagler | Dietitian, Registered | 1522 Halifax Way, El Dorado Hills, CA 95762-5841 | 2020-11-05 |
| 1427659796 | Yun Chieh Huang | Dietitian, Registered | 733 W Naomi Ave, Arcadia, CA 91007-7561 | 2020-11-03 |
| 1497356794 | Jelena Etemovic | Dietitian, Registered | 2517 S Alma St Apt 1, San Pedro, CA 90731-5738 | 2020-11-03 |
| 1588264337 | Apple Red Nutrition Services | Dietitian, Registered | 357 W. 2nd St, Suite #2, Loma Linda, CA 92354 | 2020-10-30 |
| 1912507708 | Eileen Hsiung | Dietitian, Registered | 830 Polaris Dr, Tustin, CA 92782-1720 | 2020-10-29 |
| 1912507831 | Aneeta Maria Vedula | Dietitian, Registered | 4371 Lombard Ave, Fremont, CA 94536-4929 | 2020-10-29 |
| 1336749449 | Sd Nutrition Group | Dietitian, Registered | 4295 Gesner St Ste 3a2, San Diego, CA 92117-6646 | 2020-10-28 |
| 1952901373 | Rubit Quintero-cobian | Dietitian, Registered | 3557 Willis Dr, Napa, CA 94558-2452 | 2020-10-26 |
| Find all providers with the same taxonomy | ||||
| City | THOUSAND OAKS |
| Zip Code | 91361 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.