DEIRDRE NICOLE CARLSON


Address: 2745 De Ovan Ave, Stockton, CA 95204-1419
Phone: 7632346196

DEIRDRE NICOLE CARLSON (NPI# 1932721610) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1932721610
Entity Type Individual
Full Name DEIRDRE NICOLE CARLSON
Credential RDN
Practice Address 2745 De Ovan Ave
Stockton
CA 95204-1419
Practice Telephone 7632346196
Mailing Telephone 7632346196
Enumeration Date 2020-05-15
Last Update Date 2020-05-15
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 133V00000X Dietitian, Registered 1092827 CA Dietary & Nutritional Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
CA REGISTERED DIETITIAN/REGISTERED DIETITIAN NUTRITIONIST 1092827 01

Office Location

Street Address 2745 DE OVAN AVE
City STOCKTON
State CA
Zip Code 95204-1419

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1962027524 Kariem Abdelwahed Licensed Vocational Nurse 1630 N. Edison St Stockton Ca, Stockton, CA 95204 2020-06-10
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1356830947 Stockton Pace PACE Provider Organization 582 E. Harding Way, Stockton, CA 95204 2018-05-09
1790228781 Rebecca Phongsa Counselor 1947 North Calfornia Street, Suite B, Stockton, CA 95204 2016-11-23
1700332905 Serim Kang Driver 4222 N Pershing Ave, Suite D2, Stockton, CA 95204 2016-08-28
1033565544 Philip John Brereton Orthotist 466 E Harding Way, Stockton, CA 95204 2016-05-13
1932507522 David Grayson Counselor 1621 Brookside Rd, Stockton, CA 95204 2014-12-12
1174934897 Gurtej Malhi Internal Medicine 1901 N California Street, Stockton, CA 95204 2014-05-15
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Taxonomy Information

Taxonomy Code 133V00000X
Grouping Dietary & Nutritional Service Providers
Classification Dietitian, Registered

Taxonomy Definition

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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1245875327 Kongpeng C Moua Dietitian, Registered 425 N California St Ste 7, Stockton, CA 95202-2130 2019-11-12
1861979163 Melanie Henry Dietitian, Registered 1008 N San Jose St, Stockton, CA 95203-2162 2018-07-19
1518407048 Central Valley Diabetes Self Management Program Dietitian, Registered 445 W Weber Ave Ste 128c, Stockton, CA 95203-3146 2017-03-02
1568781482 Tamara A Weese Dietitian, Registered 1617 N California St Ste 2g, Stockton, CA 95204-6117 2010-05-18
1033391701 Mary K Denyer Dietitian, Registered 18421 S Highway 215, Stockton, MO 65785-7330 2007-12-04
1326234220 Allison Loutanda Boyd Dietitian, Registered 445 W Weber Ave, Suite 128c, Stockton, CA 95203-3151 2007-09-24
1407927239 Christine Marie Lewallen Dietitian, Registered 2233 Grand Canal Blvd Ste 106, Stockton, CA 95207-6657 2006-11-13
1063033009 Vanessa Aldana Romo Dietitian, Registered 425 N California St Ste 7, Stockton, CA 95202-2130 2020-04-30
1417592593 Alyssa M Scotese Dietitian, Registered 425 N California St Ste 7, Stockton, CA 95202-2130 2019-11-12
1144785114 Ernie Lin Dietitian, Registered 5302 Harvest Gold Dr, Stockton, CA 95219-2432 2019-02-04
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Competitor

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City STOCKTON
Zip Code 95204

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Dataset Information

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.

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