Active NPI
Princess Medina, RD
- Registered Dietitian
- Santa Clara, CA
National Provider Identifier
1316632086
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 700 Lawrence Expy
Santa Clara, CA 95051-5173 - Phone
- (408) 851-0400
- NPI assigned
- Apr 10, 2023
- 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 | Primary |
Addresses
Primary practice location
700 Lawrence Expy
Santa Clara, CA 95051-5173
Mailing address
1948 Via Reggio CT
San Jose, CA 95132-3720
Phone (408) 623-0601
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681084800000",
"number": "1316632086",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1948 VIA REGGIO CT",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951323720",
"telephone_number": "408-623-0601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 LAWRENCE EXPY",
"city": "SANTA CLARA",
"state": "CA",
"postal_code": "950515173",
"telephone_number": "408-851-0400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA",
"first_name": "PRINCESS",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-10",
"last_updated": "2023-04-10",
"certification_date": "2023-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Clara, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.