Active NPI
Jennifer Lee Stimson, REGISTERED DIETITIAN
- Registered Dietitian
- San Mateo, CA
National Provider Identifier
1356710164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 875124
- Practice address
- 30 S Grant St
#4
San Mateo, CA 94401-2942 - Phone
- (650) 270-3198
- NPI assigned
- Sep 22, 2015
- 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 | 875124 | CA | Primary |
Addresses
Primary practice location
30 S Grant St
#4
San Mateo, CA 94401-2942
Mailing address
30 S Grant St
#4
San Mateo, CA 94401-2942
Phone (650) 270-3198
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 875124 | CA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442880000000",
"number": "1356710164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 S GRANT ST",
"address_2": "#4",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944012942",
"telephone_number": "650-270-3198"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 S GRANT ST",
"address_2": "#4",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944012942",
"telephone_number": "650-270-3198"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STIMSON",
"first_name": "JENNIFER",
"middle_name": "LEE",
"name_prefix": "Mrs.",
"credential": "REGISTERED DIETITIAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-09-22",
"last_updated": "2015-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "875124",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.