TAMMY PETROSSIAN RD, CSP, CNSD
NPI 1811210511
Dietitian, Registered - Nutrition, Pediatric in Exeter, CA

Q: What is Tammy Petrossian's NPI number?

The NPI number for Tammy Petrossian is 1811210511. It was assigned to this individual provider in the NPPES registry on March 9, 2010.

Q: What is Tammy Petrossian's specialty?

The primary specialty registered for this NPI is Dietitian, Registered, specializing in Nutrition, Pediatric, with taxonomy code 133VN1004X.

Q: When was this NPI record last updated?

The NPPES record for Tammy Petrossian was last updated on March 9, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.

Active since March 09, 2010

1014 SAN JUAN AVE, EXETER, CA 93221(559) 592-7360(559) 592-5629 Get Directions Write a Review

NPPES record last updated: March 9, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Tammy Petrossian Rd, Csp, Cnsd NPPES

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

TAMMY PETROSSIAN RD, CSP, CNSD (NPI 1811210511) is an individual nutrition, pediatric provider in Exeter, California, licensed in California (816014) and active in the NPI registry since March 2010.

NPPES Registry Identity

NPI1811210511

Entity TypeIndividualFemale

Primary Taxonomy133VN1004X

Provider Legal NameTAMMY PETROSSIANCredential: RD, CSP, CNSD

Location Address1014 SAN JUAN AVEExeter, CA 93221-1312

Mailing Address1631 E Forest Oaks DrFresno, CA 93730-4535 · (559) 434-6332

Phone(559) 592-7360

Fax(559) 592-5629

Sole ProprietorNo

Enumeration DateMarch 9, 2010

✔ NPI 1811210511 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDietitian, Registered · Nutrition, PediatricDietary & Nutritional Service Providers

Taxonomy Code133VN1004X

License✔ Licensed in CA · 816014

Definition

An individual who is a Board Certified Specialist in Pediatric Nutrition and applies evidence-based nutrition knowledge in providing medical nutrition therapy for pediatric patients. Specialists work directly with healthy and/or ill children (newborn up to 21 years of age) as well as children with special health care needs in a variety of settings (hospitals, community-based and/or family-centered programs, education programs, home, etc.), OR indirectly through management, care coordination, education, quality improvement, or research practice linked specifically to pediatric nutrition.

Also ListedDietitian, RegisteredTaxonomy 133V00000X · License 816014 (CA)

1014 SAN JUAN AVE, Exeter, CA 93221

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Other Providers at the Same Location NPPES 16

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

ALISIA D. LEE PA-C

Physician Assistant