Active NPI
Breanna Jean Butler, RDN
- Registered Dietitian
- Camp Pendleton, CA
National Provider Identifier
1104337500
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1099334
- Practice address
- 200 Mercy Circle
Camp Pendleton, CA 92055 - Phone
- (760) 719-3215
- NPI assigned
- Oct 12, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1099334 | CA | Primary |
Addresses
Primary practice location
200 Mercy Circle
Camp Pendleton, CA 92055
Mailing address
200 Mercy Circle
Camp Pendleton, CA 92055
Phone (760) 719-3215
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1099334 | CA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marjorie Nolan Cohn LLC | Dietitian, Registered | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741046400000",
"number": "1104337500",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 MERCY CIRCLE",
"city": "CAMP PENDLETON",
"state": "CA",
"postal_code": "92055",
"telephone_number": "760-719-3215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 MERCY CIRCLE",
"city": "CAMP PENDLETON",
"state": "CA",
"postal_code": "92055",
"telephone_number": "760-719-3215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTLER",
"first_name": "BREANNA",
"middle_name": "JEAN",
"credential": "RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-10-12",
"last_updated": "2025-03-04",
"certification_date": "2025-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "1099334",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Camp Pendleton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.