Active NPI
Kristine Solomon, CNC
- Nutritionist
- Montrose, CA
National Provider Identifier
1578069829
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutritionist
- License
- 2505
- Practice address
- 2232 Mira Vista Ave
Montrose, CA 91020-1506 - Phone
- (562) 631-8726
- NPI assigned
- Apr 4, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist | 133N00000X | 2505 | CA | Primary |
Addresses
Primary practice location
2232 Mira Vista Ave
Montrose, CA 91020-1506
Mailing address
2232 Mira Vista Ave
Montrose, CA 91020-1506
Phone (562) 631-8726
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2505 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675814400000",
"number": "1578069829",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2232 MIRA VISTA AVE",
"city": "MONTROSE",
"state": "CA",
"postal_code": "910201506",
"telephone_number": "562-631-8726"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2232 MIRA VISTA AVE",
"city": "MONTROSE",
"state": "CA",
"postal_code": "910201506",
"telephone_number": "562-631-8726"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOLOMON",
"first_name": "KRISTINE",
"credential": "CNC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-04-04",
"last_updated": "2023-02-08",
"certification_date": "2023-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nutritionist",
"state": "CA",
"license": "2505",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montrose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.