Kelly Pywtorak, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

847899 Issued in CA

Practice address

1330 Las Tablas Rd
Templeton, CA 93465-9758

Phone

(805) 542-6700

Fax

(805) 542-6791

NPI assigned

Sep 14, 2018

Last updated

Aug 19, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1536883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1871076893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 S BLOSSER RD",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934587310",
            "telephone_number": "805-361-8030",
            "fax_number": "805-361-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 LAS TABLAS RD",
            "city": "TEMPLETON",
            "state": "CA",
            "postal_code": "934659758",
            "telephone_number": "805-542-6700",
            "fax_number": "805-542-6791"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2800 Riverside Ave",
            "address_purpose": "LOCATION",
            "city": "Paso Robles",
            "state": "CA",
            "postal_code": "934461311",
            "country_code": "US",
            "telephone_number": "805-238-7250",
            "fax_number": "805-238-0165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PYWTORAK",
        "first_name": "KELLY",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-14",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "847899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Templeton, CA
• Providers in Templeton, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; 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.