Preventive Nutrition for Life, LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

PREVENTIVE NUTRITION FOR LIFE, LLC

Practice address

1074 Viejo Hills Dr
Lake Forest, CA 92610-3029

Phone

(949) 436-6182

NPI assigned

Jul 17, 2026

Last updated

Jul 17, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Cerissa Roman, MPH, RDNNPI 1275120883

Title

Owner

Phone

(949) 436-6182

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Cerissa Roman, MPH, RDN

  • Registered Dietitian
  • Lake Forest, CA
  • NPI 1275120883
  Authorized official Same address or phone

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

{
    "created_epoch": "1784246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784246400000",
    "number": "1457271546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1074 VIEJO HILLS DR",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926103029",
            "telephone_number": "949-436-6182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1074 VIEJO HILLS DR",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926103029",
            "telephone_number": "949-436-6182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVENTIVE NUTRITION FOR LIFE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-17",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-18",
        "status": "A",
        "authorized_official_last_name": "ROMAN",
        "authorized_official_first_name": "CERISSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-436-6182",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MPH, RDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Elizabeth Poupard, LMFT
• Sam Pourbabak, MD
• Monica Marie Powers, PSYD
• Kevin M Pratt
• Mary Connare Pratt, LCSW
• Alyssa Price, D.C.
• Stefanie Price
• Monte George Pries, PHD
• Christian Marie Prietto, M.A.
• Primitive Therapy Physical Therapy Inc

• Registered Dietitian in Lake Forest, CA
• Providers in Lake Forest, 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 17, 2026; 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.