Individual provider Active NPI

Larisa Mary Ann Gorris, RDN

  • Registered Dietitian
  • Napa, CA
National Provider Identifier
1548021173
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86131553 Issued in CA
Practice address
1443 Main St Ste 130B
Napa, CA 94559-1939
Phone
(707) 200-1178
NPI assigned
Jan 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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 86131553 CA Primary

Addresses

Primary practice location

1443 Main St Ste 130B
Napa, CA 94559-1939

Mailing address

7063 Elphick Rd
Sebastopol, CA 95472-4701
Phone (530) 210-3618

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
86131553CAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1705881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1548021173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7063 ELPHICK RD",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724701",
            "telephone_number": "530-210-3618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1443 MAIN ST STE 130B",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945591939",
            "telephone_number": "707-200-1178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORRIS",
        "first_name": "LARISA",
        "middle_name": "MARY ANN",
        "name_prefix": "Mrs.",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-22",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "86131553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Napa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; 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.