KYLIE BRENNA LEEPER (NPI# 1225599780) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225599780 |
| Entity Type | Individual |
| Full Name | KYLIE BRENNA LEEPER |
| Credential | RD |
| Practice Address |
2101 N Waterman Ave San Bernardino CA 92404-4836 |
| Mailing Address |
20338 Barnard Ave Walnut CA 91789-2468 |
| Practice Telephone | 9098839711 |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2019-03-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 86061000 | Dietary & Nutritional Service Providers | |
| N | 133VN1004X |
Dietitian, Registered Specialization: Nutrition, Pediatric |
86061000 | Dietary & Nutritional Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588212880 | Kylie Leeper | Student in an Organized Health Care Education/Training Program | 1107 N Charles G Seivers Blvd, Clinton, TN 37716-3944 | 2019-08-29 |
| Street Address |
2101 N WATERMAN AVE |
| City | SAN BERNARDINO |
| State | CA |
| Zip Code | 92404-4836 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992797153 | Young A Suk | Anesthesiology | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2005-08-15 |
| 1467077016 | Melissa Magdangal | Occupational Therapist | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2020-06-10 |
| 1902433303 | Ariel Chen | Physician Assistant | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2020-03-25 |
| 1417581059 | Western Acute Care Surgeons Inc | Surgery | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2020-02-22 |
| 1538704234 | Michelle Dela Cruz Villanueva | Occupational Therapist | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2019-11-17 |
| 1750943668 | Benjamin Arthur Rinard | Physician Assistant | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2019-07-01 |
| 1679132955 | Louis Gallo | Physician Assistant | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2019-06-10 |
| 1154984706 | Antonio Moreno | Anesthesiology | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2019-04-18 |
| 1003378944 | Miranda G Ideal | Nurse Anesthetist, Certified Registered | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2019-04-01 |
| 1720549504 | Gavin Mcmullen | Nurse Anesthetist, Certified Registered | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2019-03-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740849363 | Danniella Alexandra Murillo | Physician Assistant | 2101 North Waterman Ave, San Bernardino, CA 92404 | 2019-06-07 |
| 1902377484 | Shauntel Renee Nelson | Student in an Organized Health Care Education/Training Program | 1481 N. Windsor Dr., San Bernardino, CA 92404 | 2018-12-10 |
| 1487123584 | Garrett M Grigg | Licensed Psychiatric Technician | 1481 N Windsor Dr, San Bernardino, CA 92404 | 2018-11-19 |
| 1881163434 | James Dean Anders | Counselor | 1481 Windsor Drive, San Bernardino, CA 92404 | 2018-11-13 |
| 1043703564 | Samantha Makpaiboonvatana | Optometrist | 1909 N Waterman Ave Ste 3, San Bernardino, CA 92404 | 2018-06-09 |
| 1861981623 | Christopher Windham | Behavior Technician | 2460 Fremontia Dr, San Bernardino, CA 92404 | 2018-05-08 |
| 1891145041 | Cynthia Lusy Gastelum | Marriage & Family Therapist | 1885 E Lynwood Dr Rm Se3, San Bernardino, CA 92404 | 2016-06-20 |
| 1336598259 | Foundation Enterprises LLC | Non-emergency Medical Transport (VAN) | 1663 Date Pl., #30390, San Bernardino, CA 92404 | 2016-06-10 |
| 1881042877 | Helen Ann Thompson | Speech-Language Pathologist | 1311 E. State St., San Bernardo, CA 92404 | 2016-05-31 |
| 1366839938 | Lanecia Richardson | Counselor | 135 Paul Drive, San Rafeal, CA 92404 | 2015-04-22 |
| Find all providers in zip 92404 | ||||
| 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 |
|---|---|---|---|---|
| 1033645528 | Nellie Elizabeth Campa Perez | Dietitian, Registered | 724 Sequoia St, San Bernardino, CA 92407-2529 | 2017-05-03 |
| 1083062301 | Donna Panganiban | Dietitian, Registered | 1505 S D St, San Bernardino, CA 92408-3200 | 2016-05-26 |
| 1700130192 | Ho Sil Kang | Dietitian, Registered | 2645 Annapolis Cir, San Bernardino, CA 92408-4165 | 2012-11-07 |
| 1982908588 | Nadia Rudenko | Dietitian, Registered | 361 W 44th St, Apt 4, San Bernardino, CA 92407-3647 | 2010-12-22 |
| 1700893906 | Dorothy C Chen-maynard | Dietitian, Registered | 4951 Mariposa Dr, San Bernardino, CA 92404-1432 | 2006-08-01 |
| 1851908321 | Selyna Belle Jacobs | Dietitian, Registered | 2121 N D St, San Bernardino, CA 92405-3915 | 2020-09-28 |
| 1306451802 | Ashley Ramirez | Dietitian, Registered | 2121 N D St, San Bernardino, CA 92405-3915 | 2020-09-10 |
| 1659901429 | Maricelle Ranola | Dietitian, Registered | 410 E Parkcenter Cir N, San Bernardino, CA 92408-2869 | 2020-01-21 |
| 1144885252 | Yu-yen Lee | Dietitian, Registered | 665 N D St, San Bernardino, CA 92401-1109 | 2019-05-03 |
| 1578032512 | Adriana Wagner | Dietitian, Registered | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2018-11-20 |
| Find all providers in SAN BERNARDINO | ||||
| City | SAN BERNARDINO |
| Zip Code | 92404 |
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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.