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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 133V00000X | Dietitian, Registered | 1092827 | CA | Dietary & Nutritional Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | REGISTERED DIETITIAN/REGISTERED DIETITIAN NUTRITIONIST | 1092827 | 01 |
Street Address |
2745 DE OVAN AVE |
City | STOCKTON |
State | CA |
Zip Code | 95204-1419 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962027524 | Kariem Abdelwahed | Licensed Vocational Nurse | 1630 N. Edison St Stockton Ca, Stockton, CA 95204 | 2020-06-10 |
1831730555 | Ronnie C Murray | Counselor | 1947 North California Street, Stockton, CA 95204 | 2019-10-03 |
1235614116 | Michelle Ann Horn | Marriage & Family Therapist | 3666 Mission Rd, Stockton, CA 95204 | 2018-09-26 |
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 |
1396156170 | Rajesh Saini | Nurse Practitioner | 1805 N California St. Suite 102, Stockton, CA 95204 | 2014-05-14 |
Find all providers in zip 95204 |
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 |
---|---|---|---|---|
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 |
Find all providers in STOCKTON |
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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.