Active NPI
Lesley Anne Wiley, MS RD
- Registered Dietitian
- Campbell, CA
National Provider Identifier
1285905521
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1053707
- Practice address
- 621 E Campbell Ave Ste 6B
Campbell, CA 95008-2126 - Phone
- (408) 370-7731
- Fax
- (408) 370-7732
- NPI assigned
- Jan 18, 2012
- Last updated
- Jan 18, 2012
- 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 | 1053707 | CA | Primary |
Addresses
Primary practice location
621 E Campbell Ave Ste 6B
Campbell, CA 95008-2126
Mailing address
621 E Campbell Ave Ste 6B
Campbell, CA 95008-2126
Phone (408) 370-7731
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1053707 | CA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bay Area Nutrition, LLC | Dietitian, Registered | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326844800000",
"number": "1285905521",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "621 E CAMPBELL AVE STE 6B",
"city": "CAMPBELL",
"state": "CA",
"postal_code": "950082126",
"telephone_number": "408-370-7731",
"fax_number": "408-370-7732"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "621 E CAMPBELL AVE STE 6B",
"city": "CAMPBELL",
"state": "CA",
"postal_code": "950082126",
"telephone_number": "408-370-7731",
"fax_number": "408-370-7732"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILEY",
"first_name": "LESLEY",
"middle_name": "ANNE",
"name_prefix": "Mrs.",
"credential": "MS RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-01-18",
"last_updated": "2012-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "1053707",
"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 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.