Individual provider Active NPI

Jessica Lynn Yanez, RD

  • Registered Dietitian
  • Northridge, CA
National Provider Identifier
1063181576
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1058790 Issued in CA
Practice address
8510 Balboa Blvd Ste 150
Northridge, CA 91325-5810
Phone
(818) 357-5000
NPI assigned
Sep 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

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 1058790 CA Primary

Addresses

Primary practice location

8510 Balboa Blvd Ste 150
Northridge, CA 91325-5810

Mailing address

11333 Moorpark St # 143
Studio City, CA 91602-2618
Phone (203) 768-2882

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
1058790CAMDRegistered Dietitian

Interoperability endpoints

  • Direct secure messaging: jessica.yanez.p1@direct.lakeside.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1631059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1063181576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11333 MOORPARK ST # 143",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916022618",
            "telephone_number": "203-768-2882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8510 BALBOA BLVD STE 150",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913255810",
            "telephone_number": "818-357-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANEZ",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-08",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "1058790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; 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.