Wan Yi Wang, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86074218 Issued in CA

Practice address

3230 E Imperial Hwy Ste 300
Brea, CA 92821-6751

Phone

(559) 740-3967

NPI assigned

Mar 9, 2022

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

Other names 1

• Yi Wan Wang Former name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nutri-Life LLCGroup PAC ID 3971049800, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Nutri-Life LLC

  • Registered Dietitian
  • Brea, CA
  • NPI 1699552620

  Dietitian, Registered

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1646784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1306593280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23781 VIA EL ROCIO",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926913533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3230 E IMPERIAL HWY STE 300",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928216751",
            "telephone_number": "559-740-3967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "WAN",
        "middle_name": "YI",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-09",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "86074218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YI",
            "last_name": "WANG",
            "middle_name": "WAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Walmart Inc.
• Walmart, Inc.
• John Walthart, LMFT
• Eileen Wang, PHARMD
• Tiffany Wang, DDS
• Sarwat Bashir Waraich, PSY.D.
• Warby Parker Inc.
• Warren J. Schlott D.D.S. Inc
• Valerie Cripps Warren, PT, ATP, CBIS
• Joanne Elaine Washington

• Registered Dietitian in Brea, CA
• Providers in Brea, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.