Individual provider Active NPI

Kelli Patin, RD, CDE

  • Registered Dietitian
  • Walnut Creek, CA
National Provider Identifier
1619425584
Registry record updated Jul 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1000860 Issued in CA
Practice address
106 La Casa Via
Suite 100
Walnut Creek, CA 94598-3086
Phone
(925) 239-2900
Fax
(925) 932-2456
NPI assigned
Sep 20, 2016
Last updated
Jul 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1000860 CA Primary
Pediatric Nutrition Registered Dietitian 133VN1004X 1000860 CA

Addresses

Primary practice location

106 La Casa Via
Suite 100
Walnut Creek, CA 94598-3086

Mailing address

106 La Casa Via
Suite 100
Walnut Creek, CA 94598-3086
Phone (925) 239-2900

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

LicenseStateTypeSpecialty
1000860CAMDPediatric Nutrition Registered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1474329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785369600000",
    "number": "1619425584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 LA CASA VIA",
            "address_2": "SUITE 100",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983086",
            "telephone_number": "925-239-2900",
            "fax_number": "925-932-2456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 LA CASA VIA",
            "address_2": "SUITE 100",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983086",
            "telephone_number": "925-239-2900",
            "fax_number": "925-932-2456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATIN",
        "first_name": "KELLI",
        "credential": "RD, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-20",
        "last_updated": "2026-07-30",
        "certification_date": "2026-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "1000860",
            "primary": true
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "CA",
            "license": "1000860",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2026; 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.