Coastal Cities Nutrition Group

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

COASTAL CITIES NUTRITION GROUP

Practice address

1302 Madera Rd Ste 2
Simi Valley, CA 93065-4019

Phone

(805) 404-8082

NPI assigned

Dec 19, 2018

Organization subpart

No

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

Authorized official

Name

Bonnie Jean Broek, RDN

Title

Owner

Phone

(805) 404-8082

Specialties & licenses 5

Addresses

Locations

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

{
    "created_epoch": "1545177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788220800000",
    "number": "1376015016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 MADERA RD STE 2",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930654019",
            "telephone_number": "805-404-8082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 MADERA RD STE 2",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930654019",
            "telephone_number": "805-404-8082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CITIES NUTRITION GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-19",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A",
        "authorized_official_last_name": "BROEK",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-404-8082",
        "authorized_official_credential": "RDN"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Simi Valley, CA
• Providers in Simi Valley, 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 1, 2026; 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.