Individual provider Active NPI

Tallene Hacatoryan

  • Registered Dietitian
  • Newport Beach, CA
National Provider Identifier
1902313752
Registry record updated Jan 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86022316 Issued in CA
Practice address
1220 Bison Ave Ste A6
Newport Beach, CA 92660-4261
Phone
(949) 632-3118
NPI assigned
Jan 2, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2018

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 86022316 CA Primary

Addresses

Primary practice location

1220 Bison Ave Ste A6
Newport Beach, CA 92660-4261

Mailing address

1966 Port Locksleigh PL
Newport Beach, CA 92660-6616

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
86022316CAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1514851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514851200000",
    "number": "1902313752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1966 PORT LOCKSLEIGH PL",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926606616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 BISON AVE STE A6",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926604261",
            "telephone_number": "949-632-3118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACATORYAN",
        "first_name": "TALLENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-02",
        "last_updated": "2018-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "86022316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2018; 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.