Active NPI
Amy Pao
- Registered Dietitian
- Hayward, CA
National Provider Identifier
1639712870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 254 Jackson St
Hayward, CA 94544-1907 - Phone
- (510) 583-1255
- NPI assigned
- Oct 21, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | Primary |
Addresses
Primary practice location
254 Jackson St
Hayward, CA 94544-1907
Mailing address
10858 McPeak LN
Dublin, CA 94568-5500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 991162 | Other | CDR |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | amy.pao@davita.com |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571616000000",
"number": "1639712870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10858 MCPEAK LN",
"city": "DUBLIN",
"state": "CA",
"postal_code": "945685500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "254 JACKSON ST",
"city": "HAYWARD",
"state": "CA",
"postal_code": "945441907",
"telephone_number": "510-583-1255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAO",
"first_name": "AMY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-21",
"last_updated": "2019-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CDR",
"identifier": "991162",
"state": null
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "amy.pao@davita.com",
"affiliation": "N",
"endpointDescription": "email",
"address_1": "254 Jackson St",
"city": "Hayward",
"state": "CA",
"country_code": "US",
"postal_code": "945441907",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Hayward, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.