Active NPI
Lynne Martin, R.D.
- Registered Dietitian
- San Rafael, CA
National Provider Identifier
1063731057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 953786
- Practice address
- 523 4TH St
Suite 100
San Rafael, CA 94901-3310 - Phone
- (415) 505-2387
- NPI assigned
- May 31, 2010
- 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 | 953786 | CA | Primary |
Addresses
Primary practice location
523 4TH St
Suite 100
San Rafael, CA 94901-3310
Mailing address
523 4TH St
Suite 100
San Rafael, CA 94901-3310
Phone (415) 505-2387
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 |
|---|---|---|---|
| 953786 | CA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1275264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422921600000",
"number": "1063731057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "523 4TH ST",
"address_2": "SUITE 100",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949013310",
"telephone_number": "415-505-2387"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "523 4TH ST",
"address_2": "SUITE 100",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949013310",
"telephone_number": "415-505-2387"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "LYNNE",
"credential": "R.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-05-31",
"last_updated": "2015-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "953786",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Rafael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.