Individual provider Active NPI

Carol B. Granados, M.S.,R.D.,C.D.E.

  • Registered Dietitian
  • Burbank, CA
National Provider Identifier
1225293947
Registry record updated Jul 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
717322 Issued in CA
Practice address
501 S Buena Vista St
Burbank, CA 91505-4809
Phone
(818) 847-3478
Fax
(818) 847-3484
NPI assigned
Jul 22, 2008
Last updated
Jul 22, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2008

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 717322 CA Primary

Addresses

Primary practice location

501 S Buena Vista St
Burbank, CA 91505-4809

Mailing address

10842 Keywest Ave
Northridge, CA 91326-2621
Phone (818) 831-9077

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
717322CAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216684800000",
    "number": "1225293947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10842 KEYWEST AVE",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913262621",
            "telephone_number": "818-831-9077",
            "fax_number": "818-847-3484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S BUENA VISTA ST",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054809",
            "telephone_number": "818-847-3478",
            "fax_number": "818-847-3484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANADOS",
        "first_name": "CAROL",
        "middle_name": "B.",
        "name_prefix": "Mrs.",
        "credential": "M.S.,R.D.,C.D.E.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-22",
        "last_updated": "2008-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "717322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; 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.