MEDICARE: JOCELYN C PROTOPAPPAS RDN, MSW, MPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WD0400X	Diabetes Educator Registered Nurse	LD-D-10190590	OR
2	133V00000X	Registered Dietitian	DI60861109	WA

General Provider Information

NPI Number	:	1083018204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOCELYN C PROTOPAPPAS RDN, MSW, MPH

Provider Business Mailing Address
First Line	:	5160 1/2 W POINT LOMA BLVD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92107-1315
Country	:	US
Telephone Number	:	717-683-8314
Fax Number	:

Provider Business Practice Location Address
First Line	:	4231 BALBOA AVE # 785
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92117-5504
Country	:	US
Telephone Number	:	717-683-8314
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2014
Last Update Date	:	01/02/2026

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