Fernanda Pizzatto Brusamolin, CN, CHWC

Primary specialty

NutritionistTaxonomy code 133N00000X

License

NU2013 Issued in WA

Practice address

4110 Sorrento Valley Blvd
San Diego, CA 92121-1429

Phone

(858) 246-9730

NPI assigned

Aug 31, 2022

Last updated

Aug 31, 2022By the provider in NPPES

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

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": "1661904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1184344020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 TENOR",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926181796",
            "telephone_number": "858-242-2341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 SORRENTO VALLEY BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211429",
            "telephone_number": "858-246-9730"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "179 Tenor",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "CA",
            "postal_code": "926181796",
            "country_code": "US",
            "telephone_number": "858-242-2341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUSAMOLIN",
        "first_name": "FERNANDA",
        "middle_name": "PIZZATTO",
        "credential": "CN, CHWC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-31",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "WA",
            "license": "NU2013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Stephen Brush
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• Laurel Kay Brust, LCSW
• Johnnisha Brutus

• Nutritionist in San Diego, CA
• Providers in San Diego, CA by specialty
• Nutritionist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; 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.