| Breanna Pottebaum, | |
|
944 Palm Ave Apt 5, West Hollywood, CA 90069-4017 | |
| (952) 300-0907 | |
| Not Available |
| Full Name | Breanna Pottebaum |
|---|---|
| Gender | Female |
| Speciality | Registered Dietitian Or Nutrition Professional |
| Experience | 5 Years |
| Location | 944 Palm Ave Apt 5, West Hollywood, California |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487482857 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | 86154650 (Minnesota) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Nourish, Inc. | 1557724937 | 288 |
| Provider Name | Nourish, Inc. |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1558097824 PECOS PAC ID: 1557724937 Enrollment ID: O20230901000471 |
| Mailing Address | Practice Location Address |
|---|---|
| Breanna Pottebaum, 944 Palm Ave Apt 5, West Hollywood, CA 90069-4017 Ph: (952) 300-0907 | Breanna Pottebaum, 944 Palm Ave Apt 5, West Hollywood, CA 90069-4017 Ph: (952) 300-0907 |
Miss Christine Lynn Scarcello, MS, RD, CNSC Dietitian Medicare: Not Enrolled in Medicare Practice Location: 8700 Beverly Blvd, West Hollywood, CA 90048 Phone: 630-309-0025 |
Yoseline Raquel Jordan, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 8700 Beverly Blvd, West Hollywood, CA 90048 Phone: 310-423-3277 |
Cedars-sinai Medical Center Dietitian Medicare: Not Enrolled in Medicare Practice Location: 8700 Beverly Blvd, West Hollywood, CA 90048 Phone: 310-423-3444 Fax: 310-423-0189 |
Matthew Miley, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1141 Hacienda Pl, #7, West Hollywood, CA 90069 Phone: 310-991-6941 |
Abigail Gooding, R.D. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 8700 Beverly Blvd, West Hollywood, CA 90048 Phone: 310-423-4511 |
Lauren Julia Amaral, MS, RD, CSO Dietitian Medicare: Not Enrolled in Medicare Practice Location: 8700 Beverly Blvd # Ac1003b, West Hollywood, CA 90048 Phone: 310-248-7656 |
Ms. Svetlana Kasman, R.D., L.AC. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 7855 Santa Monica Blvd, West Hollywood, CA 90046 Phone: 310-275-3835 |