Individual provider Active NPI

Christine Wan

  • Registered Dietitian
  • Pasadena, CA
National Provider Identifier
1861852592
Registry record updated Feb 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
916269 Issued in CA
Practice address
126 S Catalina Ave Unit 202
Pasadena, CA 91106-2908
Phone
(626) 589-8330
NPI assigned
Feb 23, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2016

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 916269 CA Primary

Addresses

Primary practice location

126 S Catalina Ave Unit 202
Pasadena, CA 91106-2908

Mailing address

126 S Catalina Ave Unit 202
Pasadena, CA 91106-2908
Phone (626) 589-8330

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

LicenseStateTypeSpecialty
916269CAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1456185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456185600000",
    "number": "1861852592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 S CATALINA AVE UNIT 202",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911062908",
            "telephone_number": "626-589-8330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 S CATALINA AVE UNIT 202",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911062908",
            "telephone_number": "626-589-8330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAN",
        "first_name": "CHRISTINE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-23",
        "last_updated": "2016-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "916269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.

Verify at the official NPI Registry.