Kristina Pestana, CNS, LDN

Primary specialty

NutritionistTaxonomy code 133N00000X

License

DX4628 Issued in MD

Practice address

412 Elden St
Herndon, VA 20170-4511

Phone

(703) 657-0303

NPI assigned

Feb 6, 2019

Last updated

Sep 22, 2022By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Specialist

State licenses

Practice roles

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.

• Juno Wellness

  • Nutritionist
  • Herndon, VA
  • NPI 1265155337
  NPD Authorized official
• My Dr's Pharmacy

  • Community/Retail Pharmacy
  • Herndon, VA
  • NPI 1629426648
  NPD (past)

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

{
    "created_epoch": "1549411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1619432333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1126 N TAYLOR ST",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222014789",
            "telephone_number": "786-205-4044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 ELDEN ST",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704511",
            "telephone_number": "703-657-0303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESTANA",
        "first_name": "KRISTINA",
        "credential": "CNS, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-06",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "MD",
            "license": "DX4628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD OF DIETETIC PRACTICE",
            "identifier": "DX4628",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Bischoff Pedicano, MD
• Jasmine Pennington
• Reyna Jasmin Perez-Arreaga
• Susan Perlmutter, M.D.
• Simone Perry
• Lisa Tam Petruzzi, ATC, VATL
• Brian Andrew Petz, ATC
• Doan Trinh Thuy Pham, FNP-C
• Jennifer Hope Pham
• Katherine J. Phillips, L.C. S.W.

• Nutritionist in Herndon, VA
• Providers in Herndon, VA by specialty
• Nutritionist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; 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.