Miranda Natalia Carpenter, RD
Individual provider Active NPI Registered Dietitian · Sebastopol, CA
NPI 1912633710 · NPPES record last updated Jul 26, 2022
Key facts
- NPI
- 1912633710
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 86198734 (CA)
- Practice address
- 652 Petaluma Ave
Sebastopol, CA 95472-4256 - Phone
- (707) 823-3166
- NPI assigned
- Jul 26, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86198734 | CA | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86198734 | CA | Yes |
Addresses
Primary practice location
652 Petaluma Ave
Sebastopol, CA 95472-4256
Mailing address
652 Petaluma Ave
Sebastopol, CA 95472-4256
Phone (707) 823-3166
Other providers in Sebastopol, CA
- John Peter Canova
- Lesley Aviva Cantor
- Canvas and Connection Therapy: a MFT and Art Therapy Corporation
- Megan Carlock
- Mary Ann Carpenter
- Anne Casey-Nielson
- Emilce Castro Deller
- Sara Champie
- Charlene Renee Chan
- Valerie Chan
All providers in Sebastopol, CA · Registered Dietitian in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 26, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.