Holly Benson Peck, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

01018929 Issued in CA

Practice address

19438 Desiree LN
Woodbridge, CA 95258-9264

Phone

(408) 623-4290

NPI assigned

Sep 5, 2023

Last updated

Sep 5, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1693872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1568248698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19438 DESIREE LN",
            "city": "WOODBRIDGE",
            "state": "CA",
            "postal_code": "952589264",
            "telephone_number": "408-623-4290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19438 DESIREE LN",
            "city": "WOODBRIDGE",
            "state": "CA",
            "postal_code": "952589264",
            "telephone_number": "408-623-4290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "HOLLY",
        "middle_name": "BENSON",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-05",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "01018929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Woodbridge, CA
• Providers in Woodbridge, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.