Active NPI
Stacy Nicole Casucci, RDN
- Registered Dietitian
- Los Angeles, CA
National Provider Identifier
1043889926
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86037217
- Practice address
- 420 E 3Rd St
Los Angeles, CA 90013-1644 - Phone
- (213) 625-0706
- NPI assigned
- Jun 23, 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86037217 | CA | Primary |
Addresses
Primary practice location
420 E 3Rd St
Los Angeles, CA 90013-1644
Mailing address
827 Grevelia St Apt a
South Pasadena, CA 91030-2437
Phone (323) 837-8177
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
| License | State | Type | Specialty |
|---|---|---|---|
| 86037217 | CA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668211200000",
"number": "1043889926",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "827 GREVELIA ST APT A",
"city": "SOUTH PASADENA",
"state": "CA",
"postal_code": "910302437",
"telephone_number": "323-837-8177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 E 3RD ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900131644",
"telephone_number": "213-625-0706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASUCCI",
"first_name": "STACY",
"middle_name": "NICOLE",
"name_prefix": "Mrs.",
"credential": "RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-06-23",
"last_updated": "2022-11-12",
"certification_date": "2022-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "86037217",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.