MEDICARE: REMEDY ROOTS NUTRITON LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	133V00000X	Registered Dietitian
2	133VN1005X	Renal Nutrition Registered Dietitian
3	133VN1301X	Oncology Nutrition Registered Dietitian
4	133VN1401X	Pediatric Critical Care Nutrition Registered Dietitian
5	133VN1501X	Sports Dietetics Nutrition Registered Dietitian
6	133VN1201X	Obesity and Weight Management Nutrition Registered Dietitian

General Provider Information

NPI Number	:	1912857533
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REMEDY ROOTS NUTRITON LLC

Provider Business Mailing Address
First Line	:	4661 SIERRA VISTA AVE APT 303
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92505-8532
Country	:	US
Telephone Number	:	415-307-9853
Fax Number	:

Provider Business Practice Location Address
First Line	:	3540 12TH ST # 5
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92501-3802
Country	:	US
Telephone Number	:	415-307-9853
Fax Number	:

Authorized Official
Title or Position	:	DIETITIAN
Name	:	MISS ILSA ARIAS
Credential	:	RDN
Telephone Number	:	415-307-9853

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	02/02/2026

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