Active NPI
Izell Marie Rodriguez, RDN
- Registered Dietitian
- Riverside, CA
National Provider Identifier
1508528019
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86007564
- Practice address
- 16123 Washington St
Riverside, CA 92504-5954 - Phone
- (951) 556-9703
- NPI assigned
- Oct 12, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 | 86007564 | CA | Primary |
Addresses
Primary practice location
16123 Washington St
Riverside, CA 92504-5954
Mailing address
16123 Washington St
Riverside, CA 92504-5954
Phone (951) 556-9703
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | www.nutrizzynutritionandwellnessllc.com |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 86007564 | CA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633996800000",
"number": "1508528019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16123 WASHINGTON ST",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925045954",
"telephone_number": "951-556-9703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16123 WASHINGTON ST",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925045954",
"telephone_number": "951-556-9703"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "IZELL",
"middle_name": "MARIE",
"credential": "RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-10-12",
"last_updated": "2021-10-12",
"certification_date": "2021-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "86007564",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "www.nutrizzynutritionandwellnessllc.com",
"affiliation": "N",
"address_1": "16123 Washington St",
"city": "Riverside",
"state": "CA",
"country_code": "US",
"postal_code": "925045954",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.