Organization Active NPI

Jalapeno Health, LLC

  • Registered Dietitian
  • Temecula, CA
National Provider Identifier
1295400851
Registry record updated Aug 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
JALAPENO HEALTH, LLC
Doing business as
Jalapeno Health, LLC
Practice address
30983 Putter Cir
Temecula, CA 92591-3922
Phone
(510) 364-9794
NPI assigned
Aug 14, 2021
Last updated
Aug 14, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2021

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

Authorized official

Name
Carol Wong, RDNPI 1205459658
Title
Owner
Phone
(510) 364-9794

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)CodeLicenseStatePrimary
Registered Dietitian 133V00000X Primary

Addresses

Primary practice location

30983 Putter Cir
Temecula, CA 92591-3922

Mailing address

30983 Putter Cir
Temecula, CA 92591-3922
Phone (510) 364-9794

Other names 1

  • Jalapeno Health, LLC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240830000724 CA Part B Supplier - Clinic/Group Practice 4880133164 Receives reassigned benefits from 3 practitioners
Practice locations: Temecula, CA

National Provider Directory

National Provider Directory

Locations

29377 Rancho California Rd
Ste 103
Temecula, CA 92591
Phone (951) 387-5201

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": "1628899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628899200000",
    "number": "1295400851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30983 PUTTER CIR",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925913922",
            "telephone_number": "510-364-9794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30983 PUTTER CIR",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925913922",
            "telephone_number": "510-364-9794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JALAPENO HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-14",
        "last_updated": "2021-08-14",
        "certification_date": "2021-08-14",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-364-9794",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jalapeno Health, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Temecula, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2021; 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.