Active NPI
Chevon Marie Raich, RD
- Registered Dietitian
- Moreno Valley, CA
National Provider Identifier
1184321432
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86061195
- Practice address
- 27300 Iris Ave
Moreno Valley, CA 92555-4802 - Phone
- (833) 574-2273
- NPI assigned
- Feb 7, 2023
- Last updated
- Feb 7, 2023
- 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 | 86061195 | CA | Primary |
Addresses
Primary practice location
27300 Iris Ave
Moreno Valley, CA 92555-4802
Mailing address
5705 Carleton St
San Bernardino, CA 92407-2592
Phone (909) 522-7369
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 |
|---|---|---|---|
| 86061195 | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675728000000",
"number": "1184321432",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5705 CARLETON ST",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924072592",
"telephone_number": "909-522-7369"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27300 IRIS AVE",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925554802",
"telephone_number": "833-574-2273"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAICH",
"first_name": "CHEVON",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-07",
"last_updated": "2023-02-07",
"certification_date": "2023-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "86061195",
"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 7, 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.