KELLY KOYANO (NPI# 1891330783) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891330783 |
| Entity Type | Individual |
| Full Name | KELLY KOYANO |
| Credential | RD |
| Practice Address |
4168 Front St San Diego CA 92103-2030 |
| Mailing Address |
3532 Meade Ave Apt 39 San Diego CA 92116-3508 |
| Practice Telephone | 6194710420 |
| Mailing Telephone | 8052179048 |
| Enumeration Date | 2019-11-14 |
| Last Update Date | 2019-11-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 86057314 | CA | Dietary & Nutritional Service Providers |
| Street Address |
4168 FRONT ST |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92103-2030 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861459448 | Oliver Joseph Biederman | Internal Medicine | 4168 Front St, San Diego, CA 92103-2030 | 2006-04-27 |
| 1093237075 | Carla Salcedo | Dietitian, Registered | 4168 Front St, San Diego, CA 92103-2030 | 2017-07-12 |
| 1538600887 | Jonathan Cheng | Student in an Organized Health Care Education/Training Program | 4168 Front St, San Diego, CA 92103-2030 | 2017-03-19 |
| 1629487285 | Courtney Jane Thompson | Nurse Practitioner | 4168 Front St, San Diego, CA 92103-2030 | 2014-08-07 |
| 1023452554 | Karla Fernanda Torres | Nurse Practitioner | 4168 Front St, San Diego, CA 92103-2030 | 2013-04-26 |
| 1477808285 | Schafer Cale Boeder | Internal Medicine | 4168 Front St, San Diego, CA 92103-2030 | 2012-07-17 |
| 1124303011 | Nunzio Bottini | Internal Medicine | 4168 Front St, Ucsd Hillcrest Mos Arthritis, 3rd Floor, San Diego, CA 92103-2030 | 2011-10-11 |
| 1336440957 | Aleksandra Novikov | Internal Medicine | 4168 Front St, San Diego, CA 92103-2030 | 2010-11-12 |
| 1225262975 | Michele Lee Ritter | Internal Medicine | 4168 Front St, San Diego, CA 92103-2030 | 2009-05-11 |
| 1972764579 | Eva Stettner | Nurse Practitioner | 4168 Front St, 3rd Fl, San Diego, CA 92103-2030 | 2008-06-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174140057 | Carmel Agdeppa | Acupuncturist | Chiropractique, 813 West Washington St., San Diego, CA 92103 | 2020-06-26 |
| 1568082717 | Salina Ann Bambic | Social Worker | 302 Washington Street Suite 420, San Diego, CA 92103 | 2020-04-17 |
| 1467099432 | Lina Hong | Behavior Technician | 3731 6th Ave. Suite 100, San Diego, Ca 92103, San Diego, CA 92103 | 2019-12-09 |
| 1154964567 | Rodger Stacy Questin, Psychologist P.C. | Psychologist | 440 Upas St Apt 402, San Diego, CA 92103 | 2019-10-18 |
| 1932740388 | Grace Tong-ventura | Pharmacist | 200 W. Arbor Drive, #8765, Suite 1-317, San Diego, CA 92103 | 2019-10-07 |
| 1306490453 | Genevieve Cheung | Pharmacist | 200 W Arbor Dr #8765, Department of Pharmacy, San Diego, CA 92103 | 2019-07-26 |
| 1801356837 | Marika Doviak | Acupuncturist | 2370 Hickory St, San Diego, CA 92103 | 2019-03-25 |
| 1982185070 | Tyler Lewis Roberts | Counselor | 4303 3rd Ave, San Diego, CA 92103 | 2018-08-27 |
| 1689151284 | Tori Breanne Blackwell | Occupational Therapist | 3731-a 6th Avenue, San Diego, CA 92103 | 2018-07-26 |
| 1952892614 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4095 Jackdaw St, San Diego, CA 92103 | 2018-05-29 |
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| 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 |
|---|---|---|---|---|
| 1336749449 | Sd Nutrition Group | Dietitian, Registered | 4295 Gesner St Ste 3a2, San Diego, CA 92117-6646 | 2020-10-28 |
| 1629685987 | Erin Reeves | Dietitian, Registered | 8701 Lake Athabaska Way, San Diego, CA 92119-2825 | 2020-09-29 |
| 1033721907 | Feeding Your Soul Nutrition, LLC | Dietitian, Registered | 10622 Golden Willow Unit 125, San Diego, CA 92130-4930 | 2020-08-20 |
| 1043821333 | Tammy Manse | Dietitian, Registered | 2166 Pine St, San Diego, CA 92103-1523 | 2020-08-11 |
| 1992315691 | Dawn Michelle Rutherford | Dietitian, Registered | 4320 Viewridge Ave, San Diego, CA 92123-1690 | 2020-08-06 |
| 1821606344 | Andrea Michelle Kent | Dietitian, Registered | 5305 Cass St, San Diego, CA 92109-1207 | 2020-07-21 |
| 1841808003 | Sapna Bhalsod | Dietitian, Registered | 4816 W Mountain View Dr Apt 6, San Diego, CA 92116-1758 | 2020-07-14 |
| 1053937557 | Nicole Gomez | Dietitian, Registered | 4965 Corlita Ct, San Diego, CA 92122-3930 | 2020-06-19 |
| 1992320154 | Sarah Jamila Venters | Dietitian, Registered | 10379 Westward Ct, San Diego, CA 92131-6152 | 2020-06-13 |
| 1366066847 | Kathryn Baker Ward | Dietitian, Registered | 4321 Maryland St, San Diego, CA 92103-2333 | 2020-06-01 |
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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.