Healthcare Provider Details

I. General information

NPI: 1568372894
Provider Name (Legal Business Name): JESSAYRA NICOLLE TARRIO ORTIZ MS, RDN, CNSC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9449 IMPERIAL HWY
DOWNEY CA
90242-2814
US

IV. Provider business mailing address

919 MAIN ST APT 208
EL SEGUNDO CA
90245-5209
US

V. Phone/Fax

Practice location:
  • Phone: 833-574-2273
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86082291
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: