NPIMap

Organization Active NPI

Diabetes Wellness Center, a Nursing Corporation

  • Metabolic Nutrition Registered Dietitian
  • Pismo Beach, CA
National Provider Identifier
1487653036
Registry record updated May 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X
License
C2445484 Issued in CA
Legal business name
DIABETES WELLNESS CENTER, A NURSING CORPORATION
Practice address
855 4TH St
#2
Pismo Beach, CA 93449-3102
Phone
(805) 773-3130
Fax
(805) 773-3120
NPI assigned
Jul 16, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2008

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

Authorized official

Name
Kristina N Dilworth, RN, MS, FNPNPI 1407855018
Title
President
Phone
(805) 773-3130

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Metabolic Nutrition Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133VN1006X C2445484 CA Primary

Addresses

Primary practice location

855 4TH St
#2
Pismo Beach, CA 93449-3102

Mailing address

855 4TH St
#2
Pismo Beach, CA 93449-3102
Phone (805) 773-3130

National Provider Directory

National Provider Directory

Locations

855 4th St
Ste 2
Pismo Beach, CA 93449
Phone (805) 773-3130

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1121472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209945600000",
    "number": "1487653036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 4TH ST",
            "address_2": "#2",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934493102",
            "telephone_number": "805-773-3130",
            "fax_number": "805-773-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 4TH ST",
            "address_2": "#2",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934493102",
            "telephone_number": "805-773-3130",
            "fax_number": "805-773-3120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABETES WELLNESS CENTER, A NURSING CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-16",
        "last_updated": "2008-05-05",
        "status": "A",
        "authorized_official_last_name": "DILWORTH",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-773-3130",
        "authorized_official_credential": "RN, MS, FNP"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "CA",
            "license": "C2445484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pismo Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2008; 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.