Rene Gaeta, RD

Individual provider Active NPI Registered Dietitian · Alpine, CA

NPI 1740158641 · NPPES record last updated Oct 23, 2025

Key facts

NPI
1740158641
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
86150586 (CA)
Practice address
4058 Willows Rd
Alpine, CA 91901-1668
Phone
(619) 445-1188
NPI assigned
Oct 23, 2025
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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.

Medicare Care Compare profile

Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Indian Health Council (18 clinicians)

Practice addresses (Care Compare)

4058 Willows Rd
Alpine, CA 91901-1668

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20260420003687 TX Practitioner - Registered Dietitian Or Nutrition Professional 0345716981 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
86150586CAMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86150586 CA Yes

Addresses

Primary practice location

4058 Willows Rd
Alpine, CA 91901-1668

Mailing address

2766 Worden St
San Diego, CA 92110-5704
Phone (213) 562-9539

Other providers in Alpine, CA

All providers in Alpine, CA · Registered Dietitian in California

Sources for this page

Verify at the official NPI Registry.