Individual provider Active NPI

Teri Osalla, RDN

  • Registered Dietitian
  • Los Angeles, CA
National Provider Identifier
1669255766
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1045669 Issued in CA
Practice address
619 S Olive St Ste 403
Los Angeles, CA 90014-1547
Phone
(323) 391-7262
NPI assigned
Aug 14, 2023
Last updated
Aug 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1045669 CA Primary

Addresses

Primary practice location

619 S Olive St Ste 403
Los Angeles, CA 90014-1547

Mailing address

619 S Olive St Ste 403
Los Angeles, CA 90014-1547
Phone (323) 391-7262

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
1045669CAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Bamboo Nutrition Therapy, Inc. Dietitian, Registered CurrentSince Aug 27, 2023 Accepting new patients

Locations

619 S Olive St
Ste 403
Los Angeles, CA 90014
Phone (310) 897-2597

13033 Penn St
Ste 600
Whittier, CA 90602
Phone (323) 910-1108

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1669255766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 S OLIVE ST STE 403",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900141547",
            "telephone_number": "323-391-7262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 S OLIVE ST STE 403",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900141547",
            "telephone_number": "323-391-7262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSALLA",
        "first_name": "TERI",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-14",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "1045669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.