Active NPI
Tracy Walker
- Registered Dietitian
- San Diego, CA
National Provider Identifier
1649718552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 959931
- Practice address
- 4077 Fifth Ave
San Diego, CA 92103-2105 - Phone
- (619) 260-7052
- NPI assigned
- Feb 11, 2017
- 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 | 959931 | CA | Primary |
Addresses
Primary practice location
4077 Fifth Ave
San Diego, CA 92103-2105
Mailing address
4077 Fifth Ave
San Diego, CA 92103-2105
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
| License | State | Type | Specialty |
|---|---|---|---|
| 959931 | CA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486771200000",
"number": "1649718552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4077 FIFTH AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921032105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4077 FIFTH AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921032105",
"telephone_number": "619-260-7052"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "TRACY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-02-11",
"last_updated": "2017-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "959931",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.