Active NPI
Brenda Marie Goshorn, RDN
- Registered Dietitian
- Simi Valley, CA
National Provider Identifier
1760020580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 917239
- Practice address
- 2722 Beth PL
Simi Valley, CA 93065-1507 - Phone
- (805) 279-0005
- NPI assigned
- Dec 11, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 917239 | CA | Primary |
Addresses
Primary practice location
2722 Beth PL
Simi Valley, CA 93065-1507
Mailing address
2722 Beth PL
Simi Valley, CA 93065-1507
Phone (805) 279-0005
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | computer |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 917239 | CA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576022400000",
"number": "1760020580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2722 BETH PL",
"city": "SIMI VALLEY",
"state": "CA",
"postal_code": "930651507",
"telephone_number": "805-279-0005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2722 BETH PL",
"city": "SIMI VALLEY",
"state": "CA",
"postal_code": "930651507",
"telephone_number": "805-279-0005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOSHORN",
"first_name": "BRENDA",
"middle_name": "MARIE",
"credential": "RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-12-11",
"last_updated": "2019-12-11",
"certification_date": "2019-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "917239",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "computer",
"affiliation": "N",
"address_1": "2722 Beth Pl",
"city": "Simi Valley",
"state": "CA",
"country_code": "US",
"postal_code": "930651507",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Simi Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.