Individual provider Active NPI

Monique Garcia, RD

  • Registered Dietitian
  • Fullerton, CA
National Provider Identifier
1205097649
Registry record updated Aug 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
R962257 Issued in CA
Practice address
433 W Bastanchury Rd
Fullerton, CA 92835-3404
Phone
(714) 446-7867
NPI assigned
Jun 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X R962257 CA Primary

Addresses

Primary practice location

433 W Bastanchury Rd
Fullerton, CA 92835-3404

Mailing address

Dept la 21190
Pasadena, CA 91185-0001
Phone (714) 449-4800

Other identifiers 1

IdentifierTypeStateIssuer
R962257OtherCARD LIC#

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100927000024 CA Practitioner - Registered Dietitian Or Nutrition Professional 2668598723 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R962257CAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince Jul 11, 2010 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Providence Facey Medical Foundation Past Accepting new patients

Locations

955 W Imperial Hwy
Ste 220
Brea, CA 92821
Phone (714) 449-6900

1514 Valley Vista Dr
Diamond Bar, CA 91765
Phone (909) 560-1144

279 Imperial Hwy
Ste 730
Fullerton, CA 92835
Phone (714) 449-4841

433 W Bastanchury Rd
Fullerton, CA 92835
Phone (714) 446-7800

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

Dept LA 21190
Pasadena, CA 91185

2212 E 4th St
Ste 301
Santa Ana, CA 92705
Phone (714) 288-3230

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280707200000",
    "number": "1205097649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT LA 21190",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911850001",
            "telephone_number": "714-449-4800",
            "fax_number": "714-449-4956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 W BASTANCHURY RD",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353404",
            "telephone_number": "714-446-7867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "MONIQUE",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-18",
        "last_updated": "2010-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "R962257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RD LIC#",
            "identifier": "R962257",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.