Individual provider Active NPI

Danielle Judson, RDN

  • Registered Dietitian
  • Los Angeles, CA
National Provider Identifier
1477060796
Registry record updated Jan 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86073464 Issued in MA
Practice address
4009 Clayton Ave
Los Angeles, CA 90027-1560
Phone
(978) 852-3568
Fax
(978) 852-3568
NPI assigned
Jan 9, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2018

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 86073464 MA Primary

Addresses

Primary practice location

4009 Clayton Ave
Los Angeles, CA 90027-1560

Mailing address

4009 Clayton Ave Apt 1
Los Angeles, CA 90027-1560
Phone (978) 852-3568

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

LicenseStateTypeSpecialty
86073464MAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1515456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515456000000",
    "number": "1477060796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4009 CLAYTON AVE APT 1",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900271560",
            "telephone_number": "978-852-3568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4009 CLAYTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900271560",
            "telephone_number": "978-852-3568",
            "fax_number": "978-852-3568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUDSON",
        "first_name": "DANIELLE",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-09",
        "last_updated": "2018-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "86073464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2018; 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.