Tracie Chavoor, MS, RDN

Individual provider Active NPI Registered Dietitian · Santa Margarita, CA

NPI 1619656121 · NPPES record last updated Jul 12, 2023

Key facts

NPI
1619656121
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
Practice address
22673 F St
Santa Margarita, CA 93453-0740
Phone
(559) 304-0731
NPI assigned
Jul 12, 2023
Sex
Female
Sole proprietor
Yes

Medicare Care Compare profile

Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

295 Posada LN
Suite 3
Templeton, CA 93465-4055
Phone (805) 434-1166

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20231020001711 CA Practitioner - Registered Dietitian Or Nutrition Professional 8224484621 Practice locations: Templeton, CA

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Science

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X Yes

Addresses

Primary practice location

22673 F St
Santa Margarita, CA 93453-0740

Mailing address

PO Box 740
Santa Margarita, CA 93453-0740

Other providers in Santa Margarita, CA

All providers in Santa Margarita, CA · Registered Dietitian in California

Sources for this page

Verify at the official NPI Registry.