Individual provider Active NPI

Rochelle Amelia Young, RD.LDN

  • Registered Dietitian
  • Moreno Valley, CA
National Provider Identifier
1386200418
Registry record updated Apr 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2860 Issued in LA
Practice address
23180 Hemlock Ave Ste 201
Moreno Valley, CA 92557-8001
Phone
(951) 243-6460
Fax
(951) 243-5871
NPI assigned
May 14, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obesity and Weight Management Nutrition Registered Dietitian 133VN1201X 2860 LA
Registered Dietitian 133V00000X 2860 LA Primary

Addresses

Primary practice location

23180 Hemlock Ave Ste 201
Moreno Valley, CA 92557-8001

Mailing address

73043 Plantation St
Covington, LA 70435-5917
Phone (985) 705-6738

Other practice location 1

301 Main St Ste 2200
Baton Rouge, LA 70801-0014
Phone (225) 329-2337

Other identifiers 3

IdentifierTypeStateIssuer
86083909OtherCACOMMISSION ON DIETETIC REGISTRATION
2860OtherLALOUISIANA BOARD OF EXAMINERS OF DIETETIC & NUTRITION
86083909OtherLACOMMISSION 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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2860LAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lwell LLC Dietitian, Registered PastSince Aug 20, 2022 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1557792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1386200418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73043 PLANTATION ST",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704355917",
            "telephone_number": "985-705-6738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23180 HEMLOCK AVE STE 201",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925578001",
            "telephone_number": "951-243-6460",
            "fax_number": "951-243-5871"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Main St Ste 2200",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708010014",
            "country_code": "US",
            "telephone_number": "225-329-2337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "ROCHELLE",
        "middle_name": "AMELIA",
        "credential": "RD.LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-14",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1201X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": "LA",
            "license": "2860",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "LA",
            "license": "2860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMISSION ON DIETETIC REGISTRATION",
            "identifier": "86083909",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOUISIANA BOARD OF EXAMINERS OF DIETETIC & NUTRITION",
            "identifier": "2860",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMISSION ON DIETETIC REGISTRATION",
            "identifier": "86083909",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2022; 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.