Individual provider Active NPI

Julie Marie Czernik, RD, LDN

  • Registered Dietitian
  • Carson, CA
National Provider Identifier
1083442750
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
ND11686 Issued in FL
Practice address
20500 Belshaw Ave # Exca1377
Carson, CA 90746-3506
Phone
(415) 989-1017
NPI assigned
Jul 24, 2024
Last updated
Jul 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 164.003865 IL
Registered Dietitian 133V00000X ND11686 FL Primary

Addresses

Primary practice location

20500 Belshaw Ave # Exca1377
Carson, CA 90746-3506

Mailing address

20500 Belshaw Ave # Exca1377
Carson, CA 90746-3506

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
ND11686FLMDRegistered Dietitian
164.003865ILMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Vida Medical of Delaware PA Dietitian, Registered CurrentSince Jul 28, 2024 Accepting new patients

Locations

20500 Belshaw Ave
#1377
Carson, CA 90746
Phone (415) 989-1017

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1721779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1083442750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20500 BELSHAW AVE # EXCA1377",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907463506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20500 BELSHAW AVE # EXCA1377",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907463506",
            "telephone_number": "415-989-1017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CZERNIK",
        "first_name": "JULIE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "RD, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-24",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164.003865",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND11686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; 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.