Active NPI
Stacey Hickel, RD
- Renal Nutrition Registered Dietitian
- Sacramento, CA
National Provider Identifier
1629250964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Renal Nutrition Registered Dietitian
- License
- 881956
- Practice address
- 2221 Stockton Blvd
Suite B
Sacramento, CA 95817-1418 - Phone
- (916) 734-6528
- NPI assigned
- Nov 28, 2007
- 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 |
|---|---|---|---|---|
| Renal Nutrition Registered Dietitian | 133VN1005X | 881956 | CA | Primary |
Addresses
Primary practice location
2221 Stockton Blvd
Suite B
Sacramento, CA 95817-1418
Mailing address
4851 Kokomo Dr
#7324
Sacramento, CA 95835-1840
Phone (916) 470-9715
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 881956 | CA | MD | Renal Nutrition Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196208000000",
"number": "1629250964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4851 KOKOMO DR",
"address_2": "#7324",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958351840",
"telephone_number": "916-470-9715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2221 STOCKTON BLVD",
"address_2": "SUITE B",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958171418",
"telephone_number": "916-734-6528"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKEL",
"first_name": "STACEY",
"name_prefix": "Miss",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-28",
"last_updated": "2007-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1005X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Renal",
"state": "CA",
"license": "881956",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.