Olutosin Kirya, DTR, CLT

Primary specialty

Registered Dietetic TechnicianTaxonomy code 136A00000X

License

86143459 Issued in CA

Practice address

31654 Rancho Viejo Rd Ste G
San Juan Capistrano, CA 92675-2774

Phone

(949) 899-8361

NPI assigned

May 3, 2018

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

State licenses

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

{
    "created_epoch": "1525305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525305600000",
    "number": "1023507282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2867",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926900867",
            "telephone_number": "949-614-6354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31654 RANCHO VIEJO RD STE G",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926752774",
            "telephone_number": "949-899-8361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRYA",
        "first_name": "OLUTOSIN",
        "credential": "DTR, CLT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-03",
        "last_updated": "2018-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "136A00000X",
            "taxonomy_group": "",
            "desc": "Dietetic Technician, Registered",
            "state": "CA",
            "license": "86143459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dan Hakjae Kim, D.C.
• Deisy Kim, MA
• Katharine Sujin Kim
• Michael Jong-Gyu Kim, D.D.S
• Bryan O King, M.D.
• Tyler Kist, PT, DPT
• Barbara Lee Klein-Robuck, MS, RN
• Brian Klein
• Jeffrey Alan Klein, MD
• Cheryl Lynn Klem, LMFT

• Registered Dietetic Technician in San Juan Capistrano, CA
• Providers in San Juan Capistrano, CA by specialty
• Registered Dietetic Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2018; 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.