Individual provider Active NPI

Jacqueline Lao, REGISTERED DIETITIAN

  • Registered Dietitian
  • Monterey Park, CA
National Provider Identifier
1073707774
Registry record updated Sep 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
948542 Issued in CA
Practice address
917 E Newmark Ave
Apt#D
Monterey Park, CA 91755-3134
Phone
(626) 573-8182
NPI assigned
Sep 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 948542 CA Primary

Addresses

Primary practice location

917 E Newmark Ave
Apt#D
Monterey Park, CA 91755-3134

Mailing address

917 E Newmark Ave
Apt#D
Monterey Park, CA 91755-3134
Phone (626) 573-8182

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
948542CAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188950400000",
    "number": "1073707774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 E NEWMARK AVE",
            "address_2": "APT#D",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917553134",
            "telephone_number": "626-573-8182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 E NEWMARK AVE",
            "address_2": "APT#D",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917553134",
            "telephone_number": "626-573-8182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAO",
        "first_name": "JACQUELINE",
        "name_prefix": "Ms.",
        "credential": "REGISTERED DIETITIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-05",
        "last_updated": "2007-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "948542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.