Wanda Louise Grant, REGISTERED DIETITIAN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

413840 Issued in WA

Practice address

8710 Clubhouse Blvd
Desert Hot Springs, CA 92240-1166

Phone

(760) 668-9289

NPI assigned

Jan 4, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1546560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546560000000",
    "number": "1487127114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8710 CLUBHOUSE BLVD",
            "city": "DESERT HOT SPRINGS",
            "state": "CA",
            "postal_code": "922401166",
            "telephone_number": "760-668-9289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8710 CLUBHOUSE BLVD",
            "city": "DESERT HOT SPRINGS",
            "state": "CA",
            "postal_code": "922401166",
            "telephone_number": "760-668-9289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "WANDA",
        "middle_name": "LOUISE",
        "credential": "REGISTERED DIETITIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-04",
        "last_updated": "2019-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "413840",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "413840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jazmin G Gonzales
• Luis Gonzalez
• Stephanie Kay Gorman, MFT
• Andrew Page Graham
• Laura Elizabeth Granillo Giles
• Gravity Treatment Centers, Inc
• Shannon Gray
• Gregory L McFarland, O.D., Inc. (Desert EyeCare Center)
• Gun Gil Lee, DDS, Inc. (DHS Dental)
• Sandra Eileen Gune, D.C.

• Registered Dietitian in Desert Hot Springs, CA
• Providers in Desert Hot Springs, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2019; 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.