Individual provider Active NPI

Maiyu Allana Fernandez, RDN

  • Registered Dietitian
  • Oakland, CA
National Provider Identifier
1649643966
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DI100000981 Issued in DC
Practice address
306 Lee St Apt 210
Oakland, CA 94610-4346
Phone
(202) 725-8742
NPI assigned
Nov 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DX4833 MD
Registered Dietitian 133V00000X DI100000981 DC Primary

Addresses

Primary practice location

306 Lee St Apt 210
Oakland, CA 94610-4346

Mailing address

306 Lee St Apt 210
Oakland, CA 94610-4346
Phone (202) 725-8742

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

LicenseStateTypeSpecialty
DI100000981DCMDRegistered Dietitian
DX4833MDMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1447027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1649643966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 LEE ST APT 210",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946104346",
            "telephone_number": "202-725-8742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 LEE ST APT 210",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946104346",
            "telephone_number": "202-725-8742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "MAIYU",
        "middle_name": "ALLANA",
        "name_prefix": "Miss",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-09",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MD",
            "license": "DX4833",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "DC",
            "license": "DI100000981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; 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.