Active NPI
Magnolia Vela
- Registered Dietitian
- Long Beach, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- MNT894684
- Practice address
- 6285 E Spring St # 284
Long Beach, CA 90808-4020 - Phone
- (562) 424-4055
- Fax
- (949) 577-4880
- NPI assigned
- Oct 17, 2006
- Last updated
- Jun 21, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Renal Nutrition Registered Dietitian | 133VN1005X | MNT894684 | CA | |
| Metabolic Nutrition Registered Dietitian | 133VN1006X | MNT894684 | CA | |
| Nutrition Education Nutritionist | 133NN1002X | MNT894684 | CA | |
| Registered Dietitian | 133V00000X | MNT894684 | CA | Primary |
Addresses
Primary practice location
6285 E Spring St # 284
Long Beach, CA 90808-4020
Mailing address
6285 E Spring St # 284
Long Beach, CA 90808-4020
Phone (562) 424-4055
Other practice location 1
990 Highway 287 N
Mansfield, TX 76063-2607
Phone (562) 424-4055
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MNT894684 | Other | CA | REG DIETICIAN PROVIDER NO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, TX
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MNT894684 | CA | MD | Metabolic Nutrition Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nutrition As Therapy Inc. | Dietitian, Registered | Current | Accepting new patients |
| Nutrition As Therapy Inc. | Dietitian, Registered | Current | Accepting new patients |
| Nutrition As Therapy | Past | Accepting new patients | |
| Omnicare Medical Group, Inc | Past | Accepting new patients |
Locations
9750 Flower St
Bellflower, CA 90706
Phone (562) 281-9675
3711 Long Beach Blvd
Ste 904
Long Beach, CA 90807
Phone (562) 424-4055
6285 E Spring St
Long Beach, CA 90808
Phone (562) 204-6026
990 Highway 287 N
Mansfield, TX 76063
Phone (214) 334-2190
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Organizations & group practices 5
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.
-
- Community/Behavioral Health Agency
- Villa Park, CA
- NPI 1801619358
-
- Clinic/Center
- Bellflower, CA
- NPI 1134590896
-
- Health Maintenance Organization
- Lynwood, CA
- NPI 1457548604
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687305600000",
"number": "1083795231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6285 E SPRING ST # 284",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908084020",
"telephone_number": "562-424-4055",
"fax_number": "949-577-4880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6285 E SPRING ST # 284",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908084020",
"telephone_number": "562-424-4055",
"fax_number": "949-577-4880"
}
],
"practiceLocations": [
{
"address_1": "990 Highway 287 N",
"address_purpose": "LOCATION",
"city": "Mansfield",
"state": "TX",
"postal_code": "760632607",
"country_code": "US",
"telephone_number": "562-424-4055",
"fax_number": "949-577-4880",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VELA",
"first_name": "MAGNOLIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-17",
"last_updated": "2023-06-21",
"certification_date": "2023-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1005X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Renal",
"state": "CA",
"license": "MNT894684",
"primary": false
},
{
"code": "133VN1006X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Metabolic",
"state": "CA",
"license": "MNT894684",
"primary": false
},
{
"code": "133NN1002X",
"taxonomy_group": "",
"desc": "Nutritionist, Nutrition, Education",
"state": "CA",
"license": "MNT894684",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "MNT894684",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REG DIETICIAN PROVIDER NO",
"identifier": "MNT894684",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.