Individual provider Active NPI

Tianna Nilsen, M.S., R.D.

  • Registered Dietitian
  • Murrieta, CA
National Provider Identifier
1558895383
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1069733 Issued in CA
Practice address
29970 Technology Dr Ste 118
Murrieta, CA 92563-2647
Phone
(760) 716-1274
NPI assigned
Apr 19, 2017
Last updated
Jan 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 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 1069733 CA Primary

Addresses

Primary practice location

29970 Technology Dr Ste 118
Murrieta, CA 92563-2647

Mailing address

29970 Technology Dr Ste 118
Murrieta, CA 92563-2647
Phone (951) 365-7193

Other names 1

  • Tianna Smith Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240118000378 CA Practitioner - Registered Dietitian Or Nutrition Professional 4284086943 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Temecula Dietitians, Inc.Group PAC ID 3375995038, 3 clinicians

Practice addresses (Care Compare)

29970 Technology Dr
Suite 118
Murrieta, CA 92563-2647
Phone (951) 365-7193

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1069733CAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Temecula Dietitians, Inc. Dietitian, Registered CurrentSince Nov 11, 2023 Accepting new patients
Dr Brooke Bellomio Psychologist Apc PastSince Jan 21, 2024 Accepting new patients

Locations

29970 Technology Dr
Ste 105D
Murrieta, CA 92563
Phone (951) 346-0064

29970 Technology Dr
Ste 118
Murrieta, CA 92563
Phone (760) 716-1274

917 SW Oak St
Ste 303
Portland, OR 97205
Phone (971) 200-0482

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1492560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1558895383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29970 TECHNOLOGY DR STE 118",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925632647",
            "telephone_number": "951-365-7193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29970 TECHNOLOGY DR STE 118",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925632647",
            "telephone_number": "760-716-1274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NILSEN",
        "first_name": "TIANNA",
        "credential": "M.S., R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-19",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "1069733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIANNA",
            "last_name": "SMITH",
            "credential": "M.S., R.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Murrieta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.