Communal Table Wellness, LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

COMMUNAL TABLE WELLNESS, LLC

Doing business as

Communal Table Wellness

Practice address

601 W Houston Ave
Fullerton, CA 92832-3113

Phone

(860) 348-3281

NPI assigned

Nov 30, 2023

Last updated

Nov 30, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Elizabeth Lee, MS, RDNPI 1932552494

Title

Owner/Dietitian

Phone

(860) 348-3281

Specialties & licenses 1

Addresses

Other names 1

• Communal Table Wellness Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Elizabeth Lee, MS RD

  • Registered Dietitian
  • Fullerton, CA
  • NPI 1932552494

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1701302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701302400000",
    "number": "1598531659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 W VALENCIA DR # 278",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928334034",
            "telephone_number": "860-348-3281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W HOUSTON AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928323113",
            "telephone_number": "860-348-3281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNAL TABLE WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-30",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER/DIETITIAN",
        "authorized_official_telephone_number": "860-348-3281",
        "authorized_official_credential": "MS, RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Communal Table Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.