Marilou Fraire, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

987777 Issued in CA

Practice address

17296 Slover Ave
Fontana, CA 92337-7585

Phone

(909) 609-3000

NPI assigned

Apr 10, 2017

Last updated

Apr 10, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491782400000",
    "number": "1447783048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17296 SLOVER AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923377585",
            "telephone_number": "909-609-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17296 SLOVER AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923377585",
            "telephone_number": "909-609-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAIRE",
        "first_name": "MARILOU",
        "name_prefix": "Mrs.",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-10",
        "last_updated": "2017-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "987777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2017; 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.