Active NPI
Wellness Roots Foundation
- Registered Dietitian
- Simi Valley, CA
National Provider Identifier
1235921206
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Legal business name
- WELLNESS ROOTS FOUNDATION
- Practice address
- 1308 Madera Rd
Simi Valley, CA 93065-4043 - Phone
- (818) 527-2846
- NPI assigned
- May 19, 2025
- Last updated
- May 28, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ashley Glantz, REGISTERED DIETITIAN
- Title
- Cfo
- Phone
- (805) 551-1415
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | NU | Primary |
Addresses
Primary practice location
1308 Madera Rd
Simi Valley, CA 93065-4043
Mailing address
765 Wind Willow Way
Simi Valley, CA 93065-6667
Phone (805) 558-5184
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20260312003376 | CA | Part B Supplier - Clinic/Group Practice | 3274016787 | Practice locations: Simi Valley, CA |
National Provider Directory
National Provider DirectoryLocations
1308 Madera Rd
Simi Valley, CA 93065
Phone (818) 527-2846
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1747612800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1748390400000",
"number": "1235921206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "765 WIND WILLOW WAY",
"city": "SIMI VALLEY",
"state": "CA",
"postal_code": "930656667",
"telephone_number": "805-558-5184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1308 MADERA RD",
"city": "SIMI VALLEY",
"state": "CA",
"postal_code": "930654043",
"telephone_number": "818-527-2846"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WELLNESS ROOTS FOUNDATION",
"organizational_subpart": "NO",
"enumeration_date": "2025-05-19",
"last_updated": "2025-05-28",
"certification_date": "2025-05-28",
"status": "A",
"authorized_official_last_name": "GLANTZ",
"authorized_official_first_name": "ASHLEY",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "805-551-1415",
"authorized_official_credential": "REGISTERED DIETITIAN"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Simi Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; 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.