Individual provider Active NPI

Andrea Magana, REGISTERED DIETITIAN

  • Registered Dietitian
  • Port Hueneme, CA
National Provider Identifier
1508639451
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86147470 Issued in CA
Practice address
731 Joyce Dr
Port Hueneme, CA 93041-3113
Phone
(805) 663-7063
NPI assigned
Nov 2, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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 86147470 CA Primary

Addresses

Primary practice location

731 Joyce Dr
Port Hueneme, CA 93041-3113

Mailing address

731 Joyce Dr
Port Hueneme, CA 93041-3113
Phone (805) 663-7063

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
86147470CAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1698883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1508639451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 JOYCE DR",
            "city": "PORT HUENEME",
            "state": "CA",
            "postal_code": "930413113",
            "telephone_number": "805-663-7063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 JOYCE DR",
            "city": "PORT HUENEME",
            "state": "CA",
            "postal_code": "930413113",
            "telephone_number": "805-663-7063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGANA",
        "first_name": "ANDREA",
        "credential": "REGISTERED DIETITIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-02",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "86147470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Hueneme, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; 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.