CENTRAL VALLEY DIABETES SELF MANAGEMENT PROGRAM (NPI# 1518407048) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518407048 |
| Entity Type | Organization |
| Organization Name | CENTRAL VALLEY DIABETES SELF MANAGEMENT PROGRAM |
| Practice Address |
445 W Weber Ave Ste 128c Stockton CA 95203-3146 |
| Practice Telephone | 2093514735 |
| Mailing Telephone | 2093514735 |
| Enumeration Date | 2017-03-02 |
| Last Update Date | 2017-03-07 |
| Authorized Official Name | ALLISON BOYD (OWNER) |
| Authorized Official Telephone | 2093514735 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 943612 | CA | Dietary & Nutritional Service Providers |
| Street Address |
445 W WEBER AVE STE 128C |
| City | STOCKTON |
| State | CA |
| Zip Code | 95203-3146 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447899349 | Sagrario Alva Chavez | Technician | Sagrario Chavez, 1248 West Park St., Stockton, CA 95203 | 2019-12-26 |
| 1538682810 | Kumars Transport | Non-emergency Medical Transport (VAN) | 1112 W Fremont St, Stockton, CA 95203 | 2017-07-19 |
| 1194251595 | Jesmond Ridge Medical Services A Medical Corporation | Emergency Medicine | 525 W Acacla St, Stockton, CA 95203 | 2017-05-04 |
| 1285011064 | Brian Andrew Reuter | Emergency Medicine | Dameron Hospital, 525 Acacia St, Stockton, CA 95203 | 2015-04-30 |
| 1548209240 | Aaron James Simko | Pediatrics | 525 Acacia Street, Neonatal Department, Stockton, CA 95203 | 2006-06-06 |
| 1881057461 | El Concilio | Case Management | 445 N San Joaquin St, Stockton, CA 95203 | 2016-04-01 |
| 1619350634 | Sudha Vani Saduvala | Internal Medicine | 525 W Acacia St, Stockton, CA 95203 | 2015-07-08 |
| 1740621671 | Syed Salman Ali | Internal Medicine | 525 W Acacia St, Stockton, CA 95203 | 2013-07-08 |
| 1417021726 | Sahir Naseer | Emergency Medicine | 525 W Acacia St, Stockton, CA 95203 | 2006-11-20 |
| 1104312800 | Melissa Delossantos | Behavioral Analyst | 2180 Lucerne Ave, Stockton, CA 95203-1257 | 2018-07-05 |
| Find all providers in zip 95203 | ||||
| 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 |
|---|---|---|---|---|
| 1932721610 | Deirdre Nicole Carlson | Dietitian, Registered | 2745 De Ovan Ave, Stockton, CA 95204-1419 | 2020-05-15 |
| 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 |
| 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.