Active NPI
Rebecca A Sugumar, R.D.
- Registered Dietitian
- Campbell, CA
National Provider Identifier
1164794707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1051874
- Practice address
- 621 E Campbell Ave
Suite # 6 B
Campbell, CA 95008-2139 - Phone
- (408) 370-7731
- Fax
- (408) 370-7732
- NPI assigned
- Jan 28, 2012
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1051874 | CA | Primary |
Addresses
Primary practice location
621 E Campbell Ave
Suite # 6 B
Campbell, CA 95008-2139
Mailing address
844 Louise Dr
Sunnyvale, CA 94087-4138
Phone (408) 739-1897
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 14, 2025 through Mar 14, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1051874 | CA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bay Area Nutrition, LLC | Dietitian, Registered | Current | Accepting new patients |
Locations
621 E Campbell Ave
Ste 6B
Campbell, CA 95008
Phone (408) 370-7731
441 N Central Ave
Ste 2A
Campbell, CA 95008
Phone (408) 370-7731
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327708800000",
"number": "1164794707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "844 LOUISE DR",
"city": "SUNNYVALE",
"state": "CA",
"postal_code": "940874138",
"telephone_number": "408-739-1897"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "621 E CAMPBELL AVE",
"address_2": "SUITE # 6 B",
"city": "CAMPBELL",
"state": "CA",
"postal_code": "950082139",
"telephone_number": "408-370-7731",
"fax_number": "408-370-7732"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUGUMAR",
"first_name": "REBECCA",
"middle_name": "A",
"credential": "R.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-28",
"last_updated": "2012-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "1051874",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Campbell, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.