Individual provider Active NPI

Amanda Crane, RD, CLT

  • Registered Dietitian
  • San Diego, CA
National Provider Identifier
1750675880
Registry record updated Jun 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
00925602 Issued in UT
Practice address
11093 Del Diablo St
San Diego, CA 92129-1504
Phone
(619) 972-3870
Fax
(858) 672-0661
NPI assigned
Jun 7, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2011

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 00925602 UT Primary

Addresses

Primary practice location

11093 Del Diablo St
San Diego, CA 92129-1504

Mailing address

11093 Del Diablo St
San Diego, CA 92129-1504
Phone (619) 972-3870

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
00925602UTMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1307404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307404800000",
    "number": "1750675880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11093 DEL DIABLO ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921291504",
            "telephone_number": "619-972-3870",
            "fax_number": "858-672-0661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11093 DEL DIABLO ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921291504",
            "telephone_number": "619-972-3870",
            "fax_number": "858-672-0661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANE",
        "first_name": "AMANDA",
        "name_prefix": "Mrs.",
        "credential": "RD, CLT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-07",
        "last_updated": "2011-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "UT",
            "license": "00925602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2011; 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.