John Siritaranukul, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1082098 Issued in CA

Practice address

2716 Ocean Park Blvd
Suite 3020
Santa Monica, CA 90405-5207

Phone

(310) 829-9161

Fax

(310) 919-3567

NPI assigned

Apr 22, 2016

Last updated

Jan 3, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Ede Ca at Santa Monica, LP

  dba A New Journey Eating Disorder Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Santa Monica, CA
  • NPI 1033262811
  NPD (past)

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

{
    "created_epoch": "1461283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1891149118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2716 OCEAN PARK BLVD",
            "address_2": "SUITE 3020",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904055207",
            "telephone_number": "310-829-9161",
            "fax_number": "310-919-3567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2716 OCEAN PARK BLVD",
            "address_2": "SUITE 3020",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904055207",
            "telephone_number": "310-829-9161",
            "fax_number": "310-919-3567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRITARANUKUL",
        "first_name": "JOHN",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-22",
        "last_updated": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "1082098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9201 Big Horn Blvd",
            "city": "Elk Grove",
            "state": "CA",
            "country_code": "US",
            "postal_code": "957581240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Devika Singh, B.A., M.A., PH.D.
• Harman Singh, FNP
• Neha Chiruvolu Singh, DO
• Theodore Walter Siok
• Lucille I Sipert
• David W. Sirkin, M.D.
• Nancy D. Sisti, LMFT
• Jessica Janaki Sivakumar, APRN
• Six Impossible
• Skin by Lovely

• Registered Dietitian in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.