Individual provider Active NPI

Tatiana Maria Attobra

  • Registered Dietitian
  • Wildomar, CA
National Provider Identifier
1346908118
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86046414 Issued in NU
Practice address
36320 Inland Valley Dr Ste 101
Wildomar, CA 92595-7512
Phone
(951) 698-3000
NPI assigned
Nov 29, 2021
Last updated
Nov 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86046414 NU Primary

Addresses

Primary practice location

36320 Inland Valley Dr Ste 101
Wildomar, CA 92595-7512

Mailing address

29352 Flame Tree
Lake Elsinore, CA 92530-4779
Phone (805) 276-2717

Other identifiers 1

IdentifierTypeStateIssuer
86046414OtherCOMMISSION ON DIETETIC REGISTRATION

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1638144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1346908118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29352 FLAME TREE",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304779",
            "telephone_number": "805-276-2717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36320 INLAND VALLEY DR STE 101",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925957512",
            "telephone_number": "951-698-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATTOBRA",
        "first_name": "TATIANA",
        "middle_name": "MARIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-29",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": "86046414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMISSION ON DIETETIC REGISTRATION",
            "identifier": "86046414",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wildomar, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.