Individual provider Active NPI

Alyssa M Scotese, RDN

  • Registered Dietitian
  • Stockton, CA
National Provider Identifier
1417592593
Registry record updated Nov 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86108525 Issued in OH
Practice address
425 N California St Ste 7
Stockton, CA 95202-2130
Phone
(209) 870-5000
NPI assigned
Nov 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86108525 OH Primary

Addresses

Primary practice location

425 N California St Ste 7
Stockton, CA 95202-2130

Mailing address

425 N California St Ste 7
Stockton, CA 95202-2130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200219002446 CA Practitioner - Registered Dietitian Or Nutrition Professional 2466889134 Reassigns benefits to 1 organization
I20251017003641 TX Practitioner - Registered Dietitian Or Nutrition Professional 2466889134 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nourish, Inc.Group PAC ID 1557724937, 288 clinicians

Practice addresses (Care Compare)

3724 Jefferson St
Suite 104
Austin, TX 78731-6204
Phone (512) 693-7045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86108525OHMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Centers, Inc. CurrentSince Dec 22, 2019 Accepting new patients
Community Medical Centers, Inc. Current Accepting new patients
Nourish, Inc. Dietitian, Registered CurrentSince Aug 6, 2025 Accepting new patients
Nourished Roots, LLC Current Accepting new patients
Community Medical Centers Inc CurrentSince Dec 22, 2019 Accepting new patients

Locations

515 S Flower St
#1015
Los Angeles, CA 90071

7210 Murray Dr
Stockton, CA 95210
Phone (209) 373-2816

701 E Channel St
Stockton, CA 95202
Phone (209) 944-4700

730 N Central Ave
Tracy, CA 95376
Phone (209) 820-1500

500 Westover Dr
Sanford, NC 27330
Phone (478) 766-4000

3724 Jefferson St
Ste 104
Austin, TX 78731
Phone (512) 399-9039

Organizations & group practices 5

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": "1573516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573516800000",
    "number": "1417592593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 N CALIFORNIA ST STE 7",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952022130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 N CALIFORNIA ST STE 7",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952022130",
            "telephone_number": "209-870-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTESE",
        "first_name": "ALYSSA",
        "middle_name": "M",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-12",
        "last_updated": "2019-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OH",
            "license": "86108525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.