Individual provider Active NPI

Mikayla Kuykendall, MPH, RDN

  • Pediatric Nutrition Registered Dietitian
  • San Francisco, CA
National Provider Identifier
1548923386
Registry record updated Oct 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X
Practice address
1855 4TH St
San Francisco, CA 94143-2350
Phone
(704) 236-4801
NPI assigned
Oct 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nutrition Registered Dietitian 133VN1004X Primary

Addresses

Primary practice location

1855 4TH St
San Francisco, CA 94143-2350

Mailing address

1190 Brush Creek Dr
Pittsburg, CA 94565-6822

Other practice location 1

1300 S Eliseo Dr
Greenbrae, CA 94904-2023
Phone (704) 236-4801

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

Practice roles

OrganizationSpecialtyStatusNew patients
Marjorie Nolan Cohn LLC Past Accepting new patients
Fay Nutrition Past Accepting new patients
Nourish, Inc. Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1634601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634601600000",
    "number": "1548923386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 BRUSH CREEK DR",
            "city": "PITTSBURG",
            "state": "CA",
            "postal_code": "945656822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 4TH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432350",
            "telephone_number": "704-236-4801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 S Eliseo Dr",
            "address_purpose": "LOCATION",
            "city": "Greenbrae",
            "state": "CA",
            "postal_code": "949042023",
            "country_code": "US",
            "telephone_number": "704-236-4801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUYKENDALL",
        "first_name": "MIKAYLA",
        "credential": "MPH, RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-19",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.