PHYLLIS BERGIE-MOORE (NPI# 1164669792) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164669792 |
| Entity Type | Individual |
| Full Name | PHYLLIS BERGIE-MOORE |
| Other Name | PHYLLIS VAUGHN |
| Credential | RD |
| Practice Address |
144 Stony Point Rd Santa Rosa CA 95401-4122 |
| Practice Telephone | 7075214649 |
| Practice Fax Number | 7075214628 |
| Mailing Telephone | 7075214649 |
| Mailing Fax Number | 7075214628 |
| Enumeration Date | 2009-01-20 |
| Last Update Date | 2010-04-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133VN1006X |
Dietitian, Registered Specialization: Nutrition, Metabolic |
Dietary & Nutritional Service Providers |
| Street Address |
144 STONY POINT RD |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95401-4122 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518965771 | Jennifer L Betts | Family Medicine | 144 Stony Point Rd, Santa Rosa, CA 95401-4122 | 2005-07-12 |
| 1013478569 | Shaye Larie | Nurse Practitioner | 144 Stony Point Rd, Santa Rosa, CA 95401-4122 | 2019-03-27 |
| 1750853206 | Wendy Lippard | Dietitian, Registered | 144 Stony Point Rd, Santa Rosa, CA 95401-4122 | 2018-12-21 |
| 1083102560 | Mark Voorhees Darlington | Pharmacist | 144 Stony Point Rd, Santa Rosa, CA 95401-4122 | 2018-04-30 |
| 1952851016 | Chandra Matthews | Dietitian, Registered | 144 Stony Point Rd, Santa Rosa, CA 95401-4122 | 2016-10-12 |
| 1053860221 | Timothy Samuel Tong | Pharmacist | 144 Stony Point Rd, Santa Rosa, CA 95401-4122 | 2016-09-28 |
| 1982152518 | Ana Quiroz | Counselor | 144 Stony Point Rd, Santa Rosa, CA 95401 | 2016-09-12 |
| 1710330311 | Suzanne Yeomans | Social Worker | 144 Stony Point Rd, Santa Rosa, CA 95401 | 2016-07-19 |
| 1124408984 | Gloria Felling | Registered Nurse | 144 Stony Point Rd, 144 Stony Point Road, Santa Rosa, CA 95401-4122 | 2015-06-05 |
| 1639558174 | Trenae Hanaya | Registered Nurse | 144 Stony Point Rd, Santa Rosa, CA 95401-4122 | 2015-05-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972148575 | Megan Elizabeth Jones | In Home Supportive Care | 1239 Eardley Ave, Santa Rosa, CA 95401 | 2019-11-07 |
| 1801447230 | Patty Macisaac | Technician | 3221 Oak Farm Lane, Santa Rosa, CA 95401 | 2019-09-26 |
| 1386114981 | Victoria Maria Guillory | Dental Hygienist | 140 Stony Point Road, Suite A, Santa Rosa, CA 95401 | 2018-11-27 |
| 1811470727 | Chemarin Eve Boyd | Student in an Organized Health Care Education/Training Program | 1260 N Dutton Avenue, 225, Santa Rosa, CA 95401 | 2018-09-07 |
| 1073008181 | Cristavel Camacho | Behavioral Analyst | 1439 Range Ave, #101, Santa Rosa, CA 95401 | 2018-06-30 |
| 1619479102 | Victoria King | Behavior Technician | 1335 N. Dutton Ave., Santa Rosa, CA 95401 | 2018-03-01 |
| 1114436060 | Lacey Lynn Palmer | Counselor | 341 Irwin Lane, Santa Rosa, CA 95401 | 2017-09-22 |
| 1720530587 | Compassionate Homecare Solutions, LLC | In Home Supportive Care | 131 A Stony Circle, Suite 500, Santa Rosa, CA 95401 | 2016-10-27 |
| 1366998981 | William Glenn | Marriage & Family Therapist | 1496 Willowside Road, Santa Rosa, CA 95401 | 2016-09-01 |
| 1790144046 | Advocacy Home Nursing, Inc | Home Health | 1400 North Dutton Avenue, Suite 20, Santa Rosa, CA 95401 | 2016-02-15 |
| Find all providers in zip 95401 | ||||
| Taxonomy Code | 133VN1006X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| Specialization | Nutrition, Metabolic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427489277 | Barbara Birsinger | Dietitian, Registered | 175 Concourse Blvd, Santa Rosa, CA 95403-8217 | 2013-12-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477152270 | Nicole Freche | Dietitian, Registered | 210 S Palisade Dr Ste 200, Santa Maria, CA 93454-8900 | 2020-10-22 |
| 1861053134 | Diana C Andrew | Dietitian, Registered | 765 N Main St Ste 130, Corona, CA 92880-1440 | 2019-06-26 |
| 1245712272 | Monica M Lowe and Associates, LLC | Dietitian, Registered | 530 W Ojai Ave Ste 204, Ojai, CA 93023-2472 | 2018-09-06 |
| 1871079152 | Jill H Fusia | Dietitian, Registered | 1404 Cordero Court, Modesto, CA 95355 | 2018-07-19 |
| 1457873465 | Carol Faye Kane | Dietitian, Registered | 2936 Robinson Creek Ln, Elk Grove, CA 95758-3620 | 2017-07-11 |
| 1619406121 | Nutrition Care Consulting | Dietitian, Registered | 2605 Beverly Blvd, Montebello, CA 90640 | 2017-06-08 |
| 1700320439 | Julie Feldman | Dietitian, Registered | 2824 May Ave, Redondo Beach, CA 90278-1533 | 2016-12-14 |
| 1588011274 | Wisdom Foods Inc | Dietitian, Registered | 16987 Algonquin Street Suite L, Huntington Beach, CA 92649 | 2016-05-23 |
| 1881049492 | Carmen Keally | Dietitian, Registered | 12602 9th St, Garden Grove, CA 92840 | 2016-05-02 |
| 1689029878 | Andrew Woodward | Dietitian, Registered | 8455 Lodgepole Ln, Riverside, CA 92508-7105 | 2016-04-26 |
| Find all providers with the same taxonomy | ||||
| City | SANTA ROSA |
| Zip Code | 95401 |
Please comment or provide details below to improve the information on PHYLLIS BERGIE-MOORE.
| 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.