Lauren Renee Pavlov, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1060904 Issued in MI

Practice address

1441 Florida Ave
Modesto, CA 95350-4418

Phone

(209) 578-1211

NPI assigned

Jul 17, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Lauren Renee Dykstra Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1164101267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4741 DEXTER PINCKNEY RD",
            "city": "DEXTER",
            "state": "MI",
            "postal_code": "481308536",
            "telephone_number": "248-930-4573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 FLORIDA AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504418",
            "telephone_number": "209-578-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVLOV",
        "first_name": "LAUREN",
        "middle_name": "RENEE",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-17",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MI",
            "license": "1060904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "DYKSTRA",
            "middle_name": "RENEE",
            "credential": "RD, CNSC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Paula Tremayne, D.O., a Professional Medical Corporation
• Donald Scott Paulsen, PA
• Janice Dulion Paulsen, M.D.
• Susan Paulsen, RNFA
• David Jordan Pavloff
• Katerina Pavlovich
• David Merrill Paxman, D.M.D.
• David Paxton, DPM
• Adrianne Eisabel Payan, MS, CCC-SLP
• Alyse Payan

• Registered Dietitian in Modesto, CA
• Providers in Modesto, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; 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.