Julie Lyn Oldenburg, RD, CDE

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

501 E Hardy St
Suite 100
Inglewood, CA 90301-4054

Phone

(310) 680-4500

Fax

(310) 680-4505

NPI assigned

Oct 31, 2006

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

Other names 1

• Julie Lyn Havickhorst Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477639557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2503 E 21ST ST APT 104",
            "city": "SIGNAL HILL",
            "state": "CA",
            "postal_code": "907556029",
            "telephone_number": "562-597-2502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 E HARDY ST",
            "address_2": "SUITE 100",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014054",
            "telephone_number": "310-680-4500",
            "fax_number": "310-680-4505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLDENBURG",
        "first_name": "JULIE",
        "middle_name": "LYN",
        "credential": "RD, CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "HAVICKHORST",
            "middle_name": "LYN",
            "credential": "RD, CDE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Registered Dietitian in Inglewood, CA
• Providers in Inglewood, 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, 2007; 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.