KELSEA JOHANNA CREGUT (NPI# 1376906594) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376906594 |
| Entity Type | Individual |
| Full Name | KELSEA JOHANNA CREGUT |
| Other Name | KELSEA PALACE |
| Credential | RD |
| Practice Address |
400 Mobil Ave Ste D27 Camarillo CA 93010-6338 |
| Mailing Address |
5709 Cherry Ridge Dr Camarillo CA 93012-5515 |
| Practice Telephone | 8054445919 |
| Practice Fax Number | 8058301735 |
| Mailing Telephone | 8054445919 |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2019-06-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 1036705 | CA | Dietary & Nutritional Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICARE | CB280422 | 01 |
| Street Address |
400 MOBIL AVE STE D27 |
| City | CAMARILLO |
| State | CA |
| Zip Code | 93010-6338 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588261366 | Edith Gallardo | Behavior Technician | 400 Mobile Avenue Suite A-3, Camarillo, CA 93010 | 2020-10-05 |
| 1568094761 | Amanda Montoya | Physical Therapist | 58 Calle Escalon, Camarillo, CA 93010 | 2020-02-06 |
| 1518509678 | Esther Marie Brown Gonzalez | Technician | 2826 Munson St, Camarilla, CA 93010 | 2019-10-10 |
| 1023666385 | Nancy Monetta Wigert | Speech-Language Pathologist | 155 Granada Street #a, Camarillo, CA 93010 | 2019-08-29 |
| 1174098651 | Tatianna Kraft | Counselor | 4243 Vincente Ave, Camarillo, CA 93010 | 2018-10-10 |
| 1861977662 | Marina Wischnack | Psychologist | 1200 Paseo Camarillo, Suite 245, Camarillo, CA 93010 | 2018-09-27 |
| 1417430620 | Peter Lawrence Mcdermott | Anesthesiology | 141 Lapatera Drive, Camarillo, CA 93010 | 2018-09-13 |
| 1689162521 | Mehgan Lynn Lambert | Specialist | 333 Skyway Drive, Camarillo, CA 93010 | 2018-04-26 |
| 1134643208 | Hailey Kay Kohler | Social Worker | 692 Spring Oak Road Unit 721, Camarillo, CA 93010 | 2017-08-01 |
| 1174052369 | Demi Shugrue | Counselor | 2021 Sperry Ave, Suite 37, Ventura, CA 93010 | 2017-06-09 |
| Find all providers in zip 93010 | ||||
| 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 |
|---|---|---|---|---|
| 1053680462 | Mercedes Manzano | Dietitian, Registered | 2453 Woodcreek Rd, Camarillo, CA 93012-2537 | 2011-12-14 |
| 1114250024 | Laura Fuld | Dietitian, Registered | 1639 Rowland Ave, Camarillo, CA 93010-3154 | 2009-09-09 |
| 1841255874 | Debra S D'angelo | Dietitian, Registered | 133 Camino Ruiz Apt 134, Camarillo, CA 93012-6756 | 2006-04-20 |
| 1689649360 | Cedar View Health Services | Dietitian, Registered | 23 Lemon Dr, Ste A, Camarillo, CA 93010 | 2006-02-17 |
| 1265909451 | Chanel Villanueva Hinojosa | Dietitian, Registered | 400 Mobil Ave Ste D9, Camarillo, CA 93010-6376 | 2018-10-26 |
| 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 | ||||
Please comment or provide details below to improve the information on KELSEA JOHANNA CREGUT.
| 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.