Individual provider Active NPI

Jerl Jean Noval, RDN

  • Registered Dietitian
  • Redlands, CA
National Provider Identifier
1508479809
Registry record updated Apr 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
812894 Issued in CA
Practice address
1255 W Colton Ave
Redlands, CA 92374-2861
Phone
(909) 363-6533
NPI assigned
Aug 26, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 812894 CA Primary

Addresses

Primary practice location

1255 W Colton Ave
Redlands, CA 92374-2861

Mailing address

731 McAuliffe CT
Redlands, CA 92374-5480

Other practice location 1

731 McAuliffe Ct
Redlands, CA 92374-5480
Phone (909) 363-6533

Other names 1

  • Jeje Noval Other name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
812894CAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1598400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1508479809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 MCAULIFFE CT",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923745480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 W COLTON AVE",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923742861",
            "telephone_number": "909-363-6533"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "731 McAuliffe Ct",
            "address_purpose": "LOCATION",
            "city": "Redlands",
            "state": "CA",
            "postal_code": "923745480",
            "country_code": "US",
            "telephone_number": "909-363-6533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOVAL",
        "first_name": "JERL JEAN",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-26",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "812894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEJE",
            "last_name": "NOVAL",
            "credential": "RDN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Redlands, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2022; 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.