Jillian Chacon, RD

Primary specialty

Obesity and Weight Management Nutrition Registered DietitianTaxonomy code 133VN1201X

License

86295151 Issued in CA

Practice address

301 Industrial Rd
San Carlos, CA 94070-2603

Phone

(650) 853-2961

NPI assigned

Feb 9, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sutter Bay Medical Foundation

  dba Palo Alto Medial Foundation

  • Multi-Specialty Clinic/Center
  • Palo Alto, CA
  • NPI 1013950807
  Medicare reassignment NPD
• Nutrition With Jillian

  • Registered Dietitian
  • Palo Alto, CA
  • NPI 1811729882
  NPD Authorized official
• Sutter Bay Medical Foundation

  dba Sutter East Bay Medical Foundation

  • Multi-Specialty Clinic/Center
  • Orinda, CA
  • NPI 1366898538
  NPD
• Sutter Bay Medical Foundation

  dba Palo Alto Medical Foundation

  • Clinical Medical Laboratory
  • Santa Clara, CA
  • NPI 1669287033
  NPD
• Sutter East Bay Medical Foundation

  • Family Medicine Physician
  • Orinda, CA
  • NPI 1871538769
  NPD (past)

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

{
    "created_epoch": "1707436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1053175109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "650-853-2961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 INDUSTRIAL RD",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940702603",
            "telephone_number": "650-853-2961"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "330 Alvarado St",
            "address_purpose": "LOCATION",
            "city": "Brisbane",
            "state": "CA",
            "postal_code": "940051602",
            "country_code": "US",
            "telephone_number": "650-862-2280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHACON",
        "first_name": "JILLIAN",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-09",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1201X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": "CA",
            "license": "86295151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosanna Castillo
• Stephanie A Castro
• Catholic Charities Cyo of the Archdiocese of San Francisco
• Susan Elizabeth Caul, O.D.
• Mikaela Celli
• Joseph T Chambers
• Emily M Chan
• Margaret Chan, M.D.
• Sharon S Chan, M.S.
• Eun A Chang, PHARM.D

• Obesity and Weight Management Nutrition Registered Dietitian in San Carlos, CA
• Providers in San Carlos, CA by specialty
• Obesity and Weight Management Nutrition Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.