Individual provider Active NPI

Cecilia Tam

  • Nutritionist
  • French Camp, CA
National Provider Identifier
1033276886
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
853402 Issued in CA
Practice address
500 W. Hospital Rd.
French Camp, CA 95231-9989
Phone
(209) 468-6000
Fax
(209) 468-7042
NPI assigned
Jan 2, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X 853402 CA Primary

Addresses

Primary practice location

500 W. Hospital Rd.
French Camp, CA 95231-9989

Mailing address

PO Box 1020
Stockton, CA 95201-3120
Phone (209) 468-6000

Other identifiers 1

IdentifierTypeStateIssuer
853402OtherCAREGISTRATION NUMBER

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
853402CAMDNutritionist

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033276886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1020",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952013120",
            "telephone_number": "209-468-6000",
            "fax_number": "209-468-7042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W. HOSPITAL RD.",
            "city": "FRENCH CAMP",
            "state": "CA",
            "postal_code": "952319989",
            "telephone_number": "209-468-6000",
            "fax_number": "209-468-7042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAM",
        "first_name": "CECILIA",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "CA",
            "license": "853402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTRATION NUMBER",
            "identifier": "853402",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in French Camp, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.