Jennie J Guan, RND

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1082914 Issued in AZ

Practice address

650 E Indian School Rd
Phoenix, AZ 85012-1839

Phone

(602) 277-5551

NPI assigned

Jan 12, 2015

Last updated

Jan 12, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

State licenses

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.

• Phoenix VA Health Care System

  • VA Clinic/Center
  • Phoenix, AZ
  • NPI 1790022234
  Authorized official Same address or phone

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

{
    "created_epoch": "1421020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421020800000",
    "number": "1639568884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 E INDIAN SCHOOL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121839",
            "telephone_number": "602-277-5551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 E INDIAN SCHOOL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121839",
            "telephone_number": "602-277-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUAN",
        "first_name": "JENNIE",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "RND",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-12",
        "last_updated": "2015-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AZ",
            "license": "1082914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMISSION ON DIETITI REGISTRATION",
            "identifier": "1082914",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Courtney Marie Grzybowski, DO
• Allen Gu, MD
• Stephanie Guadarrama Flores
• Henry Monroe Guajardo, M.D.
• Ralph Gualtieri, MD
• Guaranteed Dental Solutions
• Guardian Angel Family Services
• Guardian Angel Home Care, Inc.
• Guardian Angel Home Healthcare
• Guardian Home Care of Az LLC

• Registered Dietitian in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Registered Dietitian in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2015; 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.