James Vincent Fazzio, R.D.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86056770 Issued in CA

Practice address

18030 Lamson Rd
Castro Vallye, CA 94546-1313

Phone

(510) 909-7594

NPI assigned

Nov 21, 2016

Last updated

Nov 21, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1479686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479686400000",
    "number": "1235672494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18030 LAMSON RD",
            "city": "CASTRO VALLYE",
            "state": "CA",
            "postal_code": "945461313",
            "telephone_number": "510-909-7594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18030 LAMSON RD",
            "city": "CASTRO VALLYE",
            "state": "CA",
            "postal_code": "945461313",
            "telephone_number": "510-909-7594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAZZIO",
        "first_name": "JAMES",
        "middle_name": "VINCENT",
        "credential": "R.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-11-21",
        "last_updated": "2016-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "86056770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2016; 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.