The Culinary Medicine Group, LLC

Primary specialty

Health & Wellness CoachTaxonomy code 171400000X

Legal business name

THE CULINARY MEDICINE GROUP, LLC

Practice address

1521 Shattuck Ave Unit 9720
Berkeley, CA 94709-9060

Phone

(510) 384-1221

NPI assigned

Mar 20, 2024

Organization subpart

No

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

Authorized official

Name

Charesa Garrett-Collin, NBC-HWC, CNC

Title

Ceo, Founder

Phone

(510) 384-1221

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1710892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710892800000",
    "number": "1124888938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 SHATTUCK AVE UNIT 9720",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947099060",
            "telephone_number": "510-384-1221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 SHATTUCK AVE UNIT 9720",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947099060",
            "telephone_number": "510-384-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CULINARY MEDICINE GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-20",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A",
        "authorized_official_last_name": "GARRETT-COLLIN",
        "authorized_official_first_name": "CHARESA",
        "authorized_official_title_or_position": "CEO, FOUNDER",
        "authorized_official_telephone_number": "510-384-1221",
        "authorized_official_credential": "NBC-HWC, CNC"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.