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HOLLY GAUTHUN RDN
NPI 1346071917
Dietitian, Registered in San Jacinto, CA

Active since August 13, 2024
1695 S SAN JACINTO AVE STE A, SAN JACINTO, CA 92583(951) 330-3100 Get Directions Write a Review

NPPES record last updated: August 13, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Holly Gauthun Rdn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HOLLY GAUTHUN RDN (NPI 1346071917) is an individual dietitian, registered in San Jacinto, California, licensed in California (86343557) and active in the NPI registry since August 2024.

NPPES Registry Identity

NPI1346071917
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameHOLLY GAUTHUNCredential: RDN
Location Address1695 S SAN JACINTO AVE STE ASan Jacinto, CA 92583-5103
Mailing Address1695 S San Jacinto Ave Ste ASan Jacinto, CA 92583-5103 · (360) 775-5337
Phone(951) 330-3100
Sole ProprietorNo
Enumeration DateAugust 13, 2024
NPPES CertifiedAugust 13, 2024
✔ NPI 1346071917 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
License✔ Licensed in CA · 86343557
Definition
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
1695 S SAN JACINTO AVE STE A, San Jacinto, CA 92583
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Holly Gauthun Rdn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Holly Gauthun reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Stallant Medical Group Inc
27 mi
Rural Health
27811 GREENSPOT RD
Highland, CA 92346
  • Reassigned Medicare billing, California enrollment
  • 21 clinicians in this Medicare group
NPI 1508683111 (912) 347-3974

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LISA GARCIA FNP
Nurse Practitioner (Family)
1695 S SAN JACINTO AVE STE A
SAN JACINTO, CA 92583
Riverside County (951) 665-1100
MS. BETH A. BOBBITT LCSW
Social Worker (Clinical)
1695 S SAN JACINTO AVE STE A
SAN JACINTO, CA 92583
Riverside County (951) 330-3100
MY DIEM NGUYEN LMSW
Social Worker (Clinical)
1695 S SAN JACINTO AVE STE A
SAN JACINTO, CA 92583
Riverside County (951) 330-3100
MR. GERSON YESTIN BRAVO LMFT, APCC
Marriage & Family Therapist
1695 S SAN JACINTO AVE STE A
SAN JACINTO, CA 92583
Riverside County (951) 330-3100
MIRIAM ELIZABETH MIRMOTAHARI NP
Nurse Practitioner (Family)
1695 S SAN JACINTO AVE STE A
SAN JACINTO, CA 92583
Riverside County (951) 330-3100
ADRIANA NAVA GODOY CHW
Community Health Worker
1695 S SAN JACINTO AVE STE A
SAN JACINTO, CA 92583
Riverside County (951) 330-3100

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Holly Gauthun's NPI number?

The NPI number for Holly Gauthun is 1346071917. It was assigned to this individual provider in the NPPES registry on August 13, 2024.

Where is Holly Gauthun located?

Holly Gauthun practices at 1695 S San Jacinto Ave Ste A, San Jacinto, CA 92583. The listed phone number is (951) 330-3100.

What is Holly Gauthun's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Holly Gauthun enrolled in Medicare?

Yes. Holly Gauthun is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Holly Gauthun's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Holly Gauthun reassigns Medicare benefits to Stallant Medical Group Inc (Highland, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Holly Gauthun's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Holly Gauthun was last updated on August 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.