Lisa Kendrick, RON

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1037565 Issued in CA

Practice address

483 N Aviation Blvd
61 Medical Squadron Laafb
El Segundo, CA 90245-2808

Phone

(310) 653-6736

NPI assigned

Feb 27, 2015

Sex

Female

Sole proprietor

Yes

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)

Enrolled

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

{
    "created_epoch": "1424995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1245622273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2447 PACIFIC COAST HWY",
            "address_2": "STE 235",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902542714",
            "telephone_number": "310-617-6806",
            "fax_number": "833-232-9769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "483 N AVIATION BLVD",
            "address_2": "61 MEDICAL SQUADRON LAAFB",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902452808",
            "telephone_number": "310-653-6736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENDRICK",
        "first_name": "LISA",
        "name_prefix": "Ms.",
        "credential": "RON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-27",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "1037565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Kelley
• Nicole Kelley
• Lily Kelly
• Madison Kelm
• Kendall S Woolridge D,D,S PC (Grand Orthodontics)
• Daishane Kendrix
• Jewel Kennedy
• Tanisha Kennedy
• Logan Kenny
• Daniel Kent

• Registered Dietitian in El Segundo, CA
• Providers in El Segundo, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; 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.