Active NPI
Amanda Regan, RD
- Pediatric Nutrition Registered Dietitian
- Dana Point, CA
National Provider Identifier
1831601095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nutrition Registered Dietitian
- License
- 86013366
- Practice address
- 24341 Pasto Rd Apt a
Dana Point, CA 92629-2219 - Phone
- (949) 874-3080
- NPI assigned
- Oct 27, 2017
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Nutrition Registered Dietitian | 133VN1004X | 86013366 | CA | Primary |
Addresses
Primary practice location
24341 Pasto Rd Apt a
Dana Point, CA 92629-2219
Mailing address
24341 Pasto Rd Apt a
Dana Point, CA 92629-2219
Phone (949) 874-3080
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 |
|---|---|---|---|
| 86013366 | CA | MD | Pediatric Nutrition Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Registered Dietitian
- San Francisco, CA
- NPI 1104334465
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1509062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707868800000",
"number": "1831601095",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24341 PASTO RD APT A",
"city": "DANA POINT",
"state": "CA",
"postal_code": "926292219",
"telephone_number": "949-874-3080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24341 PASTO RD APT A",
"city": "DANA POINT",
"state": "CA",
"postal_code": "926292219",
"telephone_number": "949-874-3080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REGAN",
"first_name": "AMANDA",
"name_prefix": "Miss",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-27",
"last_updated": "2024-02-14",
"certification_date": "2024-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1004X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Pediatric",
"state": "CA",
"license": "86013366",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dana Point, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.