NPIMap

Organization Active NPI

360 Nutrition Consulting Inc

  • Registered Dietitian
  • Camarillo, CA
National Provider Identifier
1033629175
Registry record updated Jul 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
360 NUTRITION CONSULTING INC
Practice address
400 Mobil Ave Ste D9
Camarillo, CA 93010-6376
Phone
(805) 738-5700
NPI assigned
Oct 3, 2017
Last updated
Jul 15, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2026

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

Authorized official

Name
Kelsea Johanna Palace, RDNNPI 1376906594
Title
Owner
Phone
(805) 444-5919

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133V00000X Primary

Addresses

Primary practice location

400 Mobil Ave Ste D9
Camarillo, CA 93010-6376

Mailing address

400 Mobil Ave Ste D9
Camarillo, CA 93010-6376
Phone (805) 738-5700

Other practice location 1

10510 SW Laurel Rd
Beaverton, OR 97005
Phone (805) 738-5700

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kelsea@360nutritionconsulting.com Direct
Direct Messaging Address kelsea@360nutritionconsulting.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190313001359 CA Part B Supplier - Clinic/Group Practice 8921347600 Receives reassigned benefits from 10 practitioners
Practice locations: Camarillo, CA

National Provider Directory

National Provider Directory

Locations

400 Mobil Ave
Camarillo, CA 93010
Phone (323) 240-1257

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1506988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784073600000",
    "number": "1033629175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MOBIL AVE STE D9",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930106376",
            "telephone_number": "805-738-5700",
            "fax_number": "805-738-5701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MOBIL AVE STE D9",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930106376",
            "telephone_number": "805-738-5700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10510 SW Laurel Rd",
            "address_purpose": "LOCATION",
            "city": "Beaverton",
            "state": "OR",
            "postal_code": "97005",
            "country_code": "US",
            "telephone_number": "805-738-5700",
            "fax_number": "805-738-5701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "360 NUTRITION CONSULTING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-03",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A",
        "authorized_official_last_name": "PALACE",
        "authorized_official_first_name": "KELSEA",
        "authorized_official_middle_name": "JOHANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-444-5919",
        "authorized_official_credential": "RDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kelsea@360nutritionconsulting.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "400 Mobil Ave Ste D9",
            "city": "Camarillo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "930106376",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kelsea@360nutritionconsulting.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "400 Mobil Ave Ste D9",
            "city": "Camarillo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "930106376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Camarillo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.