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Amanda Blake , MS, RD

Dietitian, Registered β€’ Simi Valley, CA

Active NPI 1225577208 Individual Practitioner Female Practitioner Accepts Medicare assignment
Practice location in NPPES

1672 Sycamore Dr Apt 302
Simi Valley, CA 930653733

Call 8054040155 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1672 Sycamore Dr Apt 302

Simi Valley, CA 930653733

Telephone 8054040155
Fax 8558825211
Other Listings in Public Data

NPPES lists 1 additional practice-address record in Studio City, CA. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Medicare Profile & Education

Source: CMS Doctors and Clinicians National Downloadable File, CMS release of October 2, 2026

Graduation Year

2015

Years since graduation

11 years (graduated 2015)

CMS Doctors and Clinicians data list 2015 as the year this clinician finished professional school.

What this does not show: Years since graduation

It is not the number of years in practice, and more years does not mean better care.

Source: CMS Doctors and Clinicians National Downloadable File, CMS release of October 2, 2026.

NPI first issued

2017

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Accepts Medicare assignment

CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians, CMS release of October 2, 2026; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians, CMS release of October 2, 2026.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Amanda Blake has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Compared with the same specialty in Simi Valley and California

26 active clinicians are listed under Dietitian, Registered with a practice address in Simi Valley, CA (7,305 in California).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Simi Valley

0% of these 26 clinicians have the CMS telehealth indicator.

3.8% of these 26 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS release of October 2, 2026, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2024-08-31
Dietitian, Registered Primary Specialty

NUCC Taxonomy Code: 133V00000X

License # reported to NPPES CA RD86027382

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.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Medical Board of California.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL

Medicare Enrollment ID

I20240927002876

Enrollment State Jurisdiction

CA

PECOS Control ID

2567993744

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Secondary Practice Locations

4160 Klump Ave

Studio City, CA 916023314

Phone: 3108013418

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

12 Historical Events
🏒
Secondary Practice Location Registered August 31, 2024

Additional practice office at 4160 Klump Ave, Studio City, CA 916023314

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Updated Practice Location August 06, 2024

Registered at 1672 SYCAMORE DR APT 302, SIMI VALLEY, CA 930653733 (Tel: 8054040155)

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Updated Business Mailing Address August 06, 2024

Registered at 1672 SYCAMORE DR APT 302, SIMI VALLEY, CA 930653733 (Tel: 8054040155)

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Updated Practice Location August 14, 2019

Registered at 2592 VICTORIA ST, SIMI VALLEY, CA 93065 (Tel: 8054040155)

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Updated Business Mailing Address August 14, 2019

Registered at 2592 VICTORIA ST, SIMI VALLEY, CA 930653736 (Tel: 8054040155)

πŸ‘€
Provider Name / Credentials Updated August 14, 2019

Recorded as AMANDA BLAKE, MS, RD

βœ…
NPI Profile Active March 01, 2017

NPI status registered as active in NPPES database

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Practice Location (Initial Record) March 01, 2017

Registered at 11301 WILSHIRE BLVD, LOS ANGELES, CA 900731003 (Tel: 3104783711)

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Business Mailing Address (Initial Record) March 01, 2017

Registered at 11301 WILSHIRE BLVD, LOS ANGELES, CA 900731003 (Tel: 3104783711)

πŸ‘€
Provider Name / Credentials (Initial Record) March 01, 2017

Recorded as AMANDA BLAKE,, MS, RD

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) March 01, 2017

Dietitian, Registered (license number reported to NPPES: CA RD86027382)

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Initial NPI Registration & Enumeration February 23, 2017

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1225577208
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 23, 2017
Last Update: August 31, 2024
Sole Proprietor: No

Other Dietitian, Registereds in Simi Valley

Healthcare providers in Simi Valley

Mailing Address

1672 Sycamore Dr Apt 302

Simi Valley, CA 930653733

Phone: 8054040155

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.