Rebecca Gail McKenzie

Primary specialty

Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X

License

86075778 Issued in CA

Practice address

18300 Ca-18
Apple Valley, CA 92307

Phone

(760) 242-2311

NPI assigned

Jan 31, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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": "1548892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1063977312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6382 N BRENDA LN",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924074039",
            "telephone_number": "909-965-2880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18300 CA-18",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "92307",
            "telephone_number": "760-242-2311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "REBECCA",
        "middle_name": "GAIL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-31",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "86075778",
            "primary": false
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "CA",
            "license": "86075778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACADEMY OF NUTRITION AND DIETETICS",
            "identifier": "86075778",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hailey Mackenzie McCullum, PTA
• Caitlin McCurley, DPT
• Angel Neeia McDaniel
• Herman Rexford McDaniel, DO
• Jeanne Marie McKellar
• Jamel McLemore
• Robin McMullen
• Kyleigh Dominque McNabb
• Zenaida Leeanne McNally
• Timothy Grant McNaughton, M.D

• Pediatric Nutrition Registered Dietitian in Apple Valley, CA
• Providers in Apple Valley, CA by specialty
• Pediatric Nutrition Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2019; 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.