Individual provider Active NPI

Kanale Kapono Rodrigues

  • Registered Dietitian
  • Riverside, CA
National Provider Identifier
1740014380
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
8876 Mission Blvd
Riverside, CA 92509-2811
Phone
(951) 272-5580
NPI assigned
Aug 27, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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 CA Primary

Addresses

Primary practice location

8876 Mission Blvd
Riverside, CA 92509-2811

Mailing address

8876 Mission Blvd
Riverside, CA 92509-2811
Phone (951) 272-5580

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250423000997 CA Practitioner - Registered Dietitian Or Nutrition Professional 6204351125 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
County of Riverside CurrentSince Apr 1, 2025 Accepting new patients
County of Riverside CurrentSince Apr 1, 2025 Accepting new patients
County of Riverside Current Accepting new patients

Locations

3055 W Ramsey St
Banning, CA 92220
Phone (951) 358-5311

308 E San Jacinto Ave
Perris, CA 92570
Phone (951) 940-6700

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1724716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1740014380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8876 MISSION BLVD",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925092811",
            "telephone_number": "951-272-5580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8876 MISSION BLVD",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925092811",
            "telephone_number": "951-272-5580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUES",
        "first_name": "KANALE",
        "middle_name": "KAPONO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-27",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.