Nicole Gilles, RD, CDE, CSR

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1034797 Issued in CA

Practice address

12523 Limonite Ave
#440-163
Mira Loma, CA 91752-3665

Phone

(951) 444-5588

Fax

(877) 991-8768

NPI assigned

Jul 30, 2012

Last updated

Dec 23, 2014By 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": "1343606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419292800000",
    "number": "1952657785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12523 LIMONITE AVE # 440-163",
            "city": "MIRA LOMA",
            "state": "CA",
            "postal_code": "917523665",
            "telephone_number": "951-444-5588",
            "fax_number": "877-991-8768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12523 LIMONITE AVE",
            "address_2": "#440-163",
            "city": "MIRA LOMA",
            "state": "CA",
            "postal_code": "917523665",
            "telephone_number": "951-444-5588",
            "fax_number": "877-991-8768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLES",
        "first_name": "NICOLE",
        "credential": "RD, CDE, CSR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-30",
        "last_updated": "2014-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "1034797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Mira Loma, CA
• Providers in Mira Loma, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2014; 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.