Active NPI
Tracy Still Jimenez, M.P.H., R.D.
- Registered Dietitian
- Agoura Hills, CA
National Provider Identifier
1467856500
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1025383
- Practice address
- 28938 Hollowbrook Ave
Agoura Hills, CA 91301-2123 - Phone
- (818) 825-4556
- NPI assigned
- Oct 17, 2014
- Last updated
- Oct 17, 2014
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1025383 | IL | Primary |
Addresses
Primary practice location
28938 Hollowbrook Ave
Agoura Hills, CA 91301-2123
Mailing address
28938 Hollowbrook Ave
Agoura Hills, CA 91301-2123
Phone (818) 825-4556
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1025383 | IL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1413504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1413504000000",
"number": "1467856500",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28938 HOLLOWBROOK AVE",
"city": "AGOURA HILLS",
"state": "CA",
"postal_code": "913012123",
"telephone_number": "818-825-4556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28938 HOLLOWBROOK AVE",
"city": "AGOURA HILLS",
"state": "CA",
"postal_code": "913012123",
"telephone_number": "818-825-4556"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JIMENEZ",
"first_name": "TRACY",
"middle_name": "STILL",
"credential": "M.P.H., R.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-17",
"last_updated": "2014-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "1025383",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Agoura Hills, CA
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- Jerold T. Litoff, a Professional Corp.
- Jie Ji
- Joelle Abed Elahad Dental Corp (The Smile Spa)
- John M. Abajian DDS a Dental Corporation
- John M. Abajian DDS a Dental Corporation
- Bobbie Lynn Johnson
- Kelly D Johnson, D.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.