Penny Lew Fevergeon, M.S., R.D.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

418881 Issued in CA

Practice address

1533 Via Fernandez
Palos Verdes Estates, CA 90274-1944

Phone

(310) 371-0813

Fax

(310) 371-6851

NPI assigned

Dec 11, 2007

Last updated

Dec 11, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197331200000",
    "number": "1023291127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1533 VIA FERNANDEZ",
            "city": "PALOS VERDES ESTATES",
            "state": "CA",
            "postal_code": "902741944",
            "telephone_number": "310-371-0813",
            "fax_number": "310-371-6851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1533 VIA FERNANDEZ",
            "city": "PALOS VERDES ESTATES",
            "state": "CA",
            "postal_code": "902741944",
            "telephone_number": "310-371-0813",
            "fax_number": "310-371-6851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEVERGEON",
        "first_name": "PENNY",
        "middle_name": "LEW",
        "name_prefix": "Mrs.",
        "credential": "M.S., R.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-11",
        "last_updated": "2007-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "418881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Carol T. Edwards, PH. D.
• Kevin M. Ehtessabian, D.D.S.
• Ryan Ali Ehtessabian, M.S., CNS
• Patricia Alice Elder, RN, IBCLC
• Fresch Services LLC. (A Place at Home)
• Tracy Georgis, R.N., N.P.
• Andrew Ghadimi, DDS
• Aimee M Goeppner, HEALTH COACH
• Gina M Golden-Tangalakis, PH.D.

• Registered Dietitian in Palos Verdes Estates, CA
• Providers in Palos Verdes Estates, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.