Foodshed Cooperative Inc

Primary specialty

Medical Foods SupplierTaxonomy code 335G00000X

Legal business name

FOODSHED COOPERATIVE INC

Practice address

3340 Fairmount Ave
San Diego, CA 92105-4228

Phone

(760) 297-0838

NPI assigned

Apr 12, 2024

Organization subpart

No

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

Authorized official

Name

Lisa Michelle Igoe

Title

Director

Phone

(760) 297-0838

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1712880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712880000000",
    "number": "1669226049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 FAIRMOUNT AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921054228",
            "telephone_number": "760-297-0838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 FAIRMOUNT AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921054228",
            "telephone_number": "760-297-0838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOODSHED COOPERATIVE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-12",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A",
        "authorized_official_last_name": "IGOE",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "760-297-0838"
    },
    "taxonomies": [
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335G00000X",
            "taxonomy_group": "",
            "desc": "Medical Foods Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron Espiritu Fontanilla
• Leanne Fontecha, LVN
• Jasmine Jane Fontenot
• Karl Micheal Fontenot Jr., LCSW
• Jill Marion Fontimayor, PHARM.D.
• Monique Nicole Foos, LMFT
• Alisa B Foote, RN
• Hope Foote
• For Eyes Optical of Ca
• Ian Foran, M.D.

• Medical Foods Supplier in San Diego, CA
• Providers in San Diego, CA by specialty
• Medical Foods Supplier in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; 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.