Active NPI
Janine Elizabeth Penha, RD, CDE
- Registered Dietitian
- San Jose, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 910306
- Practice address
- 2550 Samaritan Dr
Suite a
San Jose, CA 95124-4104 - Phone
- (707) 337-2163
- NPI assigned
- May 31, 2013
- Last updated
- May 15, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 21220047 | FL | |
| Registered Dietitian | 133V00000X | 910306 | FL | Primary |
Addresses
Primary practice location
2550 Samaritan Dr
Suite a
San Jose, CA 95124-4104
Mailing address
10645 Calle Mar de Mariposa Apt 6113
San Diego, CA 92130-8718
Phone (707) 337-2163
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
10790 Rancho Bernardo Rd
San Diego, CA 92127-5705
9834 Genesee Ave
La Jolla, CA 92037-1215
9888 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 626-4123
9896 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 626-4123
9898 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 455-9100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21220047 | FL | MD | Registered Dietitian |
| 910306 | FL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Scripps Health | Current | Accepting new patients | |
| Scripps Health | Current | Accepting new patients | |
| Scripps Health | Current | Accepting new patients | |
| Scripps Health | Dietitian, Registered | Current | Accepting new patients |
Locations
9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123
File 54433
Los Angeles, CA 90074
Phone (858) 784-5645
Interoperability endpoints
- jpenha250567@scrippshlth.medalliesdirect.net
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Scripps Hospital Medical Services
- General Acute Care Hospital
- San Diego, CA
- NPI 1487928891
-
dba Scripps Home Health Care Services
- Home Health Agency
- San Diego, CA
- NPI 1578556114
-
dba Scripps Coastal Medical Center
- Family Medicine Physician
- San Diego, CA
- NPI 1881636108
Dietitian, Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557878400000",
"number": "1396182333",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10645 CALLE MAR DE MARIPOSA APT 6113",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921308718",
"telephone_number": "707-337-2163"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2550 SAMARITAN DR",
"address_2": "SUITE A",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951244104",
"telephone_number": "707-337-2163"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENHA",
"first_name": "JANINE",
"middle_name": "ELIZABETH",
"credential": "RD, CDE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-31",
"last_updated": "2019-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "21220047",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "910306",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2019; 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.