Christine Penrose, RDN, MS

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86042653 Issued in CA

Practice address

13 Stanislaus Ave
Ventura, CA 93004-1147

Phone

(925) 699-3002

NPI assigned

Mar 27, 2023

Last updated

Jul 8, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Surfside Nutrition, LLC

  • Registered Dietitian
  • Ventura, CA
  • NPI 1053099143
  Authorized official Same address or phone

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688774400000",
    "number": "1417651266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 STANISLAUS AVE",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930041147",
            "telephone_number": "925-699-3002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 STANISLAUS AVE",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930041147",
            "telephone_number": "925-699-3002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2605 Loma Vista Rd",
            "address_purpose": "LOCATION",
            "city": "Ventura",
            "state": "CA",
            "postal_code": "930031548",
            "country_code": "US",
            "telephone_number": "805-826-1381",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENROSE",
        "first_name": "CHRISTINE",
        "credential": "RDN, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-27",
        "last_updated": "2023-07-08",
        "certification_date": "2023-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "86042653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Suzanne Pena, MD
• Adahli Penaloza
• Penfield Mtu
• Madison Shea Pennington
• Brian Penny, M.D.
• Celena Derderian Pentagulio
• Matthew K Pentland
• Jessica Pentlarge, DO
• Traci Peplinski, SLP
• Victoria Hofius Pepper, PT, DPT, MPT

• Registered Dietitian in Ventura, CA
• Providers in Ventura, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2023; 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.