Active NPI
Kacy Dyan Grossman, M.S., R.D.
- Registered Dietitian
- Los Angeles, CA
National Provider Identifier
1831542117
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1020536
- Practice address
- 1314 Westwood Blvd Ste 201
Los Angeles, CA 90024-4928 - Phone
- (805) 796-0085
- NPI assigned
- Jul 21, 2016
- 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 | 1020536 | CA | Primary |
Addresses
Primary practice location
1314 Westwood Blvd Ste 201
Los Angeles, CA 90024-4928
Mailing address
6371 Smoke Tree Ave
Oak Park, CA 91377-1249
Phone (805) 796-0085
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1020536 | CA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469059200000",
"number": "1831542117",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6371 SMOKE TREE AVE",
"city": "OAK PARK",
"state": "CA",
"postal_code": "913771249",
"telephone_number": "805-796-0085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1314 WESTWOOD BLVD STE 201",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900244928",
"telephone_number": "805-796-0085"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROSSMAN",
"first_name": "KACY",
"middle_name": "DYAN",
"credential": "M.S., R.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-07-21",
"last_updated": "2016-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "1020536",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.