Active NPI
Jeanne Reilly, M.S., R.D.
- Registered Dietitian
- La Jolla, CA
National Provider Identifier
1063840692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1108535
- Practice address
- 9850 Genesee Ave
Suite 730
La Jolla, CA 92037-1224 - Phone
- (858) 847-5064
- NPI assigned
- Oct 16, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1108535 | MA | Primary |
Addresses
Primary practice location
9850 Genesee Ave
Suite 730
La Jolla, CA 92037-1224
Mailing address
9850 Genesee Ave
Suite 730
La Jolla, CA 92037-1224
Phone (858) 847-5064
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1108535 | MA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1381881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1381881600000",
"number": "1063840692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9850 GENESEE AVE",
"address_2": "SUITE 730",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "920371224",
"telephone_number": "858-847-5064"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9850 GENESEE AVE",
"address_2": "SUITE 730",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "920371224",
"telephone_number": "858-847-5064"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REILLY",
"first_name": "JEANNE",
"credential": "M.S., R.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-10-16",
"last_updated": "2013-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MA",
"license": "1108535",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Jolla, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.