Active NPI
Natalie Black, RD/RDN
- Registered Dietitian
- Moreno Valley, CA
National Provider Identifier
1124612486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86038133
- Practice address
- 26600 Cactus Ave FL 1
Moreno Valley, CA 92555-3901 - Phone
- (951) 486-4000
- NPI assigned
- Feb 26, 2021
- Sex
- Female
- Sole proprietor
- No
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 | 86038133 | CA | Primary |
Addresses
Primary practice location
26600 Cactus Ave FL 1
Moreno Valley, CA 92555-3901
Mailing address
19847 Serrano Rd
Apple Valley, CA 92307-2605
Phone (760) 508-8439
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 |
|---|---|---|---|
| 86038133 | CA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1614297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614297600000",
"number": "1124612486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19847 SERRANO RD",
"city": "APPLE VALLEY",
"state": "CA",
"postal_code": "923072605",
"telephone_number": "760-508-8439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26600 CACTUS AVE FL 1",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925553901",
"telephone_number": "951-486-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "NATALIE",
"credential": "RD/RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-26",
"last_updated": "2021-02-26",
"certification_date": "2021-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "86038133",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moreno Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.