Individual provider Active NPI

Jacqueline Carbajal

  • Registered Dietitian
  • Glendale, AZ
National Provider Identifier
1003726381
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86374859 Issued in AZ
Practice address
18001 N 79TH Ave Ste A12
Glendale, AZ 85308-8398
Phone
(623) 399-6825
Fax
(623) 505-3474
NPI assigned
Sep 9, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86374859 AZ Primary

Addresses

Primary practice location

18001 N 79TH Ave Ste A12
Glendale, AZ 85308-8398

Mailing address

18001 N 79TH Ave Ste A12
Glendale, AZ 85308-8398
Phone (623) 399-6825

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1788912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1003726381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18001 N 79TH AVE STE A12",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088398",
            "telephone_number": "623-399-6825",
            "fax_number": "623-505-3474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18001 N 79TH AVE STE A12",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088398",
            "telephone_number": "623-399-6825",
            "fax_number": "623-505-3474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARBAJAL",
        "first_name": "JACQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-09",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AZ",
            "license": "86374859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.