Active NPI
Leah M Tanner, RD
- Renal Nutrition Registered Dietitian
- San Luis Obispo, CA
National Provider Identifier
1104121680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Renal Nutrition Registered Dietitian
- License
- 919327
- Practice address
- 84 Santa Rosa St
Suite a
San Luis Obispo, CA 93405-1812 - Phone
- (805) 548-8585
- Fax
- (805) 548-8589
- NPI assigned
- Jan 14, 2011
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Renal Nutrition Registered Dietitian | 133VN1005X | 919327 | CA | Primary |
Addresses
Primary practice location
84 Santa Rosa St
Suite a
San Luis Obispo, CA 93405-1812
Mailing address
84 Santa Rosa St
Suite a
San Luis Obispo, CA 93405-1812
Phone (805) 548-8585
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 919327 | Other | CA | AMERICAN DIETETIC ASSOCIATION MEMBERSHIP |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 919327 | CA | MD | Renal Nutrition Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415577600000",
"number": "1104121680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "84 SANTA ROSA ST",
"address_2": "SUITE A",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934051812",
"telephone_number": "805-548-8585",
"fax_number": "805-548-8589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "84 SANTA ROSA ST",
"address_2": "SUITE A",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934051812",
"telephone_number": "805-548-8585",
"fax_number": "805-548-8589"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANNER",
"first_name": "LEAH",
"middle_name": "M",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-14",
"last_updated": "2014-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1005X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Renal",
"state": "CA",
"license": "919327",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN DIETETIC ASSOCIATION MEMBERSHIP",
"identifier": "919327",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Luis Obispo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.