NPIMap

Organization Active NPI

Path Wellness LLC

  • Registered Dietitian
  • San Jose, CA
National Provider Identifier
1417536194
Registry record updated Apr 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
PATH WELLNESS LLC
Practice address
5067 Durango CT
San Jose, CA 95118-2317
Phone
(408) 598-6064
NPI assigned
Apr 7, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2021

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

Authorized official

Name
Sridevi Srinivasan, RDN, CHWCNPI 1912582263
Title
Registered Dietitian Nutritionist
Phone
(408) 598-6064

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
NutritionistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 133N00000X
Nutrition Education NutritionistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 133NN1002X
Registered DietitianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 133V00000X Primary
Health & Wellness CoachGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 171400000X

Addresses

Primary practice location

5067 Durango CT
San Jose, CA 95118-2317

Mailing address

5067 Durango CT
San Jose, CA 95118-2317
Phone (408) 598-6064

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1617753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617753600000",
    "number": "1417536194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5067 DURANGO CT",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951182317",
            "telephone_number": "408-598-6064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5067 DURANGO CT",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951182317",
            "telephone_number": "408-598-6064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATH WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-07",
        "last_updated": "2021-04-07",
        "certification_date": "2021-03-31",
        "status": "A",
        "authorized_official_last_name": "SRINIVASAN",
        "authorized_official_first_name": "SRIDEVI",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN NUTRITIONIST",
        "authorized_official_telephone_number": "408-598-6064",
        "authorized_official_credential": "RDN, CHWC"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2021; 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.