Kimberly Camille Edwards, R.D.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

912518 Issued in CA

Practice address

3610 Central Ave
Ste 400
Riverside, CA 92506-5907

Phone

(951) 330-4360

Fax

(888) 978-4430

NPI assigned

Jul 9, 2013

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

Other names 1

• Kimberly Camille Houston Former name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Elite Nutrition Services Inc.

  • Registered Dietitian
  • Riverside, CA
  • NPI 1477221307

  Dietitian, Registered

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1373328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645228800000",
    "number": "1447691274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 858",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925310858",
            "telephone_number": "951-330-4360",
            "fax_number": "888-978-4430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 CENTRAL AVE",
            "address_2": "STE 400",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925065907",
            "telephone_number": "951-330-4360",
            "fax_number": "888-978-4430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "KIMBERLY",
        "middle_name": "CAMILLE",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-09",
        "last_updated": "2022-02-19",
        "certification_date": "2022-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "912518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "HOUSTON",
            "middle_name": "CAMILLE",
            "credential": "R.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daphne Edwards
• Dejah Edwards
• Erin Edwards
• Jacob Timothy Edwards
• Jessica Nicole Edwards
• Krista Edwards
• La Honda Edwards
• Neal C Edwards, DDS
• Tyeazka Traniece Edwards, LVN
• Efren P Rodriquez DDS Inc

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.