Individual provider Active NPI

Tiffany Nicole Venegas, RDN

  • Registered Dietitian
  • Brea, CA
National Provider Identifier
1841919107
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86057236 Issued in CA
Practice address
650 Tamarack Ave Apt 4411
Brea, CA 92821-3262
Phone
(714) 603-8424
NPI assigned
Aug 22, 2022
Last updated
Aug 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86057236 CA Primary

Addresses

Primary practice location

650 Tamarack Ave Apt 4411
Brea, CA 92821-3262

Mailing address

PO Box 592
Brea, CA 92822-0592
Phone (714) 603-8424

Other names 1

  • Tiffany Nicole Quintero Former name

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
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
86057236CAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Fay Nutrition Dietitian, Registered Past Accepting new patients
Marjorie Nolan Cohn LLC Dietitian, Registered Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1661126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1841919107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 592",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928220592",
            "telephone_number": "714-603-8424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 TAMARACK AVE APT 4411",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928213262",
            "telephone_number": "714-603-8424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENEGAS",
        "first_name": "TIFFANY",
        "middle_name": "NICOLE",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "86057236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "QUINTERO",
            "middle_name": "NICOLE",
            "credential": "RDN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brea, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; 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.