R2O Nutrition LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

R2O NUTRITION LLC

Practice address

21551 Brookhurst St
Huntington Beach, CA 92646-8007

Phone

(818) 462-1932

Fax

(949) 209-2605

NPI assigned

Dec 2, 2021

Organization subpart

No

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

Authorized official

Name

Sarah Jackson, RDN

Title

RDN

Phone

(818) 462-1932

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1638403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639958400000",
    "number": "1760140248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21551 BROOKHURST ST APT 41",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926468041",
            "telephone_number": "818-462-1932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21551 BROOKHURST ST",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926468007",
            "telephone_number": "818-462-1932",
            "fax_number": "949-209-2605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R2O NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-02",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "RDN",
        "authorized_official_telephone_number": "818-462-1932",
        "authorized_official_credential": "RDN"
    },
    "taxonomies": [
        {
            "code": "133VN1201X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "86078203",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Multi-Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; 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.