Active NPI
Michiko H Lynch, RD
- Gerontological Nutrition Registered Dietitian
- Altadena, CA
National Provider Identifier
1043803059
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontological Nutrition Registered Dietitian
- License
- 931649
- Practice address
- 3589 Canyon Crest Rd
Altadena, CA 91001-3709 - Phone
- (818) 317-0501
- NPI assigned
- Feb 19, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontological Nutrition Registered Dietitian | 133VN1101X | 931649 | CA | Primary |
Addresses
Primary practice location
3589 Canyon Crest Rd
Altadena, CA 91001-3709
Mailing address
3589 Canyon Crest Rd
Altadena, CA 91001-3709
Phone (818) 317-0501
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 931649 | CA | MD | Gerontological Nutrition Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613692800000",
"number": "1043803059",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3589 CANYON CREST RD",
"city": "ALTADENA",
"state": "CA",
"postal_code": "910013709",
"telephone_number": "818-317-0501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3589 CANYON CREST RD",
"city": "ALTADENA",
"state": "CA",
"postal_code": "910013709",
"telephone_number": "818-317-0501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYNCH",
"first_name": "MICHIKO",
"middle_name": "H",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-02-19",
"last_updated": "2021-02-19",
"certification_date": "2021-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1101X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Gerontological",
"state": "CA",
"license": "931649",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Altadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.