Individual provider Active NPI

Elizabeth Laurene Von Klan, RD

  • Registered Dietitian
  • San Diego, CA
National Provider Identifier
1033986245
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86145088 Issued in CA
Practice address
4424 44TH St Apt 319
San Diego, CA 92115-4364
Phone
(408) 667-1694
NPI assigned
Dec 7, 2023
Last updated
Dec 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86145088 CA Primary

Addresses

Primary practice location

4424 44TH St Apt 319
San Diego, CA 92115-4364

Mailing address

4424 44TH St Apt 319
San Diego, CA 92115-4364
Phone (408) 667-1694

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
86145088CAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1701907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1033986245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4424 44TH ST APT 319",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921154364",
            "telephone_number": "408-667-1694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4424 44TH ST APT 319",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921154364",
            "telephone_number": "408-667-1694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VON KLAN",
        "first_name": "ELIZABETH",
        "middle_name": "LAURENE",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-07",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "86145088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; 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.