Deep Dive Nutrition

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

DEEP DIVE NUTRITION

Practice address

4653 Carmel Mountain Rd Ste 308-1018
San Diego, CA 92130-6650

Phone

(619) 943-1214

NPI assigned

Jul 8, 2022

Organization subpart

No

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

Authorized official

Name

Jeniffer Beadles, REGISTERED DIETITIANNPI 1487387197

Title

Ceo

Phone

(619) 943-1214

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeniffer Beadles, REGISTERED DIETITIAN

  • Registered Dietitian
  • San Diego, CA
  • NPI 1487387197

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1657238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657238400000",
    "number": "1841923554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4653 CARMEL MOUNTAIN RD STE 308-1018",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921306650",
            "telephone_number": "619-943-1214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4653 CARMEL MOUNTAIN RD STE 308-1018",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921306650",
            "telephone_number": "619-943-1214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEEP DIVE NUTRITION",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-08",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A",
        "authorized_official_last_name": "BEADLES",
        "authorized_official_first_name": "JENIFFER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "619-943-1214",
        "authorized_official_credential": "REGISTERED DIETITIAN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Dedman
• Brittney Taylor Dee, MOT, OTR/L
• Richard Dee
• Donald Christopher Deede
• Tracy Deen
• Melissa Evelyn Heart Deer, M.D
• Marie Melanie Deetjen, DNP-FNP
• Barabara Colleen Deets, RD
• Fernand Miguel Defante, IDC
• Bridget Taylor Defelice, NNP-BC

• Registered Dietitian in San Diego, CA
• Providers in San Diego, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.