Active NPI
Jaqueline Vivian Perez, RD
- Registered Dietitian
- San Diego, CA
National Provider Identifier
1093281875
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86050196
- Practice address
- 4338 Dawes St
San Diego, CA 92109-4103 - Phone
- (714) 928-8033
- NPI assigned
- Oct 18, 2018
- 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 | 86050196 | Primary |
Addresses
Primary practice location
4338 Dawes St
San Diego, CA 92109-4103
Mailing address
4338 Dawes St
San Diego, CA 92109-4103
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 86050196 | Other | CA | CDR |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539820800000",
"number": "1093281875",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4338 DAWES ST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921094103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4338 DAWES ST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921094103",
"telephone_number": "714-928-8033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "JAQUELINE",
"middle_name": "VIVIAN",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-10-18",
"last_updated": "2018-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": "86050196",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CDR",
"identifier": "86050196",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.