Geralyn Ann Vander Vis, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

701164 Issued in CA

Practice address

335 E Avenue I
Lancaster, CA 93535-1916

Phone

(661) 471-4336

NPI assigned

Oct 17, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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": "1508198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508457600000",
    "number": "1053822098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 496",
            "city": "ACTON",
            "state": "CA",
            "postal_code": "935100496",
            "telephone_number": "661-269-8212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 E AVENUE I",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935351916",
            "telephone_number": "661-471-4336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDER VIS",
        "first_name": "GERALYN",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-17",
        "last_updated": "2017-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "701164",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "701164",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valley Infant Pediatric & Complete Family Care
• Valley Institute of Prosthetics & Orthotics, Inc
• Valleyfootdoctor, Inc
• Enrique Hugo Vallota, M.D.
• Susan Y Vanallen, LCSW
• Julian Blake Vanderlinden, PT
• Gail Denise Vanetten
• Hlee Vang, MFT
• Surya Vanguri, ASW
• Shirley Vanwilpe

• Registered Dietitian in Lancaster, CA
• Providers in Lancaster, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2017; 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.