Integrated Nutrition Consultants LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

INTEGRATED NUTRITION CONSULTANTS LLC

Practice address

5950 Canoga Ave Ste 420
Woodland Hills, CA 91367-5037

Phone

(719) 684-5754

NPI assigned

Oct 28, 2021

Organization subpart

No

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

Authorized official

Name

Ms. Jenna Denise Moore-Liester, RD, CSSDNPI 1538655097

Title

Nutritional Operations Manager

Phone

(719) 684-5754

Specialties & licenses 1

Addresses

Other names 1

• INC Nutrition LLC Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jenna Denise Moore-Liester, RD

  • Registered Dietitian
  • Colorado Springs, CO
  • NPI 1538655097

  Dietitian, Registered

  NPD (past) Authorized official

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

{
    "created_epoch": "1635379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637712000000",
    "number": "1346904059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5950 CANOGA AVE STE 420",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913675037",
            "telephone_number": "719-684-5754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5950 CANOGA AVE STE 420",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913675037",
            "telephone_number": "719-684-5754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED NUTRITION CONSULTANTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-28",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-24",
        "status": "A",
        "authorized_official_last_name": "MOORE-LIESTER",
        "authorized_official_first_name": "JENNA",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "NUTRITIONAL OPERATIONS MANAGER",
        "authorized_official_telephone_number": "719-684-5754",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RD, CSSD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INC Nutrition LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Woodland Hills, CA
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 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.