Edna Catalina Portillo de la Cruz, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1024132 Issued in CA

Practice address

801 W Valley Blvd Ste 206
Alhambra, CA 91803-3257

Phone

(626) 283-5128

NPI assigned

Nov 30, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Edna Catalina Portillo Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1543536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1770053878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 W VALLEY BLVD STE 206",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918033257",
            "telephone_number": "626-283-5128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 W VALLEY BLVD STE 206",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918033257",
            "telephone_number": "626-283-5128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTILLO DE LA CRUZ",
        "first_name": "EDNA",
        "middle_name": "CATALINA",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-30",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "1024132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EDNA",
            "last_name": "PORTILLO",
            "middle_name": "CATALINA",
            "credential": "RD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Pocketrn Care Group Inc
• Ronald Polanco
• Kasey Alexandra Ponce
• Sabrina Monic Ponta
• Pak Nin Poon
• David Alexander Portillo-Reyes
• Sandra Libby Portillo
• Sergey Potapov
• Diana Potterveld, PA-C
• Irma Preciado

• Registered Dietitian in Alhambra, CA
• Providers in Alhambra, CA by specialty
• Registered Dietitian in California

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

Verify at the official NPI Registry.