Active NPI
Stefanie Johnson, MPH, RDN
- Registered Dietitian
- Redlands, CA
National Provider Identifier
1114897584
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1039001
- Practice address
- 26000 W Lugonia Ave
Redlands, CA 92374-5103 - Phone
- (951) 595-2041
- NPI assigned
- Nov 10, 2025
- 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 | 1039001 | CA | Primary |
Addresses
Primary practice location
26000 W Lugonia Ave
Redlands, CA 92374-5103
Mailing address
26000 W Lugonia Ave Apt 2104
Redlands, CA 92374-5105
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 |
|---|---|---|---|
| 1039001 | CA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | 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": "1762732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762732800000",
"number": "1114897584",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26000 W LUGONIA AVE APT 2104",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923745105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26000 W LUGONIA AVE",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923745103",
"telephone_number": "951-595-2041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "STEFANIE",
"credential": "MPH, RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-11-10",
"last_updated": "2025-11-10",
"certification_date": "2025-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "1039001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Redlands, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.