Caridad Aguila-Vivar, RDN

Individual provider Active NPI Registered Dietitian · Newhall, CA

NPI 1548870140 · NPPES record last updated Mar 29, 2024

Key facts

NPI
1548870140
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
925432 (CA)
Practice address
21105 Oakriver LN
Newhall, CA 91321-4686
Phone
(323) 603-6950
NPI assigned
Aug 7, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 3

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20200921002759 CA Practitioner - Registered Dietitian Or Nutrition Professional 6800214909 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
925432CAMDRegistered Dietitian

Practice roles (2 of 3)

OrganizationSpecialtyStatusNew patients
Asesu Laser Med Spa Current
since Oct 2, 2022
Accepting new patients
Care 1 Home Health Providers, Inc Past
since Mar 4, 2021
Accepting new patients

Locations

4940 Van Nuys Blvd
Ste 306
Sherman Oaks, CA 91403
Phone (626) 720-2026

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X 925432 CA
Registered Dietitian 133V00000X 925432 CA Yes

Addresses

Primary practice location

21105 Oakriver LN
Newhall, CA 91321-4686

Mailing address

21105 Oakriver LN
Newhall, CA 91321-4686
Phone (323) 603-6950

Other providers in Newhall, CA

All providers in Newhall, CA · Registered Dietitian in California

Sources for this page

Verify at the official NPI Registry.