Patricia Miranda Jardack, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

872564 Issued in CA

Practice address

10833 Le Conte Ave
37-075 CHS
Los Angeles, CA 90095-1697

Phone

(310) 825-5768

Fax

(310) 267-1054

NPI assigned

Nov 20, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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": "1542672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542672000000",
    "number": "1215406269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 OCEAN AVE APT 114",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904051040",
            "telephone_number": "310-382-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10833 LE CONTE AVE",
            "address_2": "37-075 CHS",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900951697",
            "telephone_number": "310-825-5768",
            "fax_number": "310-267-1054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1930 Ocean Ave Apt 114",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904051040",
            "country_code": "US",
            "telephone_number": "310-382-7575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JARDACK",
        "first_name": "PATRICIA",
        "middle_name": "MIRANDA",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-20",
        "last_updated": "2018-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "CA",
            "license": "872564",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "872564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RDN REGISTRATION",
            "identifier": "872564",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Siomara Jaramillo, AGACNP-BC
• Sonia Elena Jaramillo, RDN
• Katrina Jaranilla
• Kenneth Jarantilla, PA-C
• Shahriar Jarchi, M.D.
• Riviane A Jardim, NP
• Jared B Morris MD Inc
• Devon Jareo
• Jay Mouazza Jarmakani, M.D.
• Leila K Jarman

• Registered Dietitian in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2018; 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.