Nivedita Rajakumar, MS, LCGC, MA

Primary specialty

Genetic Counselor (M.S.)Taxonomy code 170300000X

License

GC000979 Issued in CA

Practice address

11852 Mount Vernon Ave Apt D425
Grand Terrace, CA 92313-8294

Phone

(916) 667-6557

NPI assigned

Apr 19, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts, Master of Science

State licenses

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

{
    "created_epoch": "1555632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555632000000",
    "number": "1164085692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST # 3400",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11852 MOUNT VERNON AVE APT D425",
            "city": "GRAND TERRACE",
            "state": "CA",
            "postal_code": "923138294",
            "telephone_number": "916-667-6557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJAKUMAR",
        "first_name": "NIVEDITA",
        "credential": "MS, LCGC, MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-19",
        "last_updated": "2019-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "CA",
            "license": "GC000979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nrajakumar@llu.edu",
            "affiliation": "N",
            "endpointDescription": "work email",
            "address_1": "11852 Mount Vernon Ave Apt D425",
            "city": "Grand Terrace",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923138294",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2019; 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.