Active NPI
Mikaela Faith Santos Marcelo, RDN
- Registered Dietitian
- Los Angeles, CA
National Provider Identifier
1669288460
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 4867 W Sunset Blvd
Los Angeles, CA 90027-5969 - Phone
- (833) 574-2273
- NPI assigned
- Dec 6, 2024
- 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 | CA | Primary |
Addresses
Primary practice location
4867 W Sunset Blvd
Los Angeles, CA 90027-5969
Mailing address
5128 Eagle Rock Blvd
Los Angeles, CA 90041-1115
Phone (323) 821-3502
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1733443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733443200000",
"number": "1669288460",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5128 EAGLE ROCK BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900411115",
"telephone_number": "323-821-3502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4867 W SUNSET BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900275969",
"telephone_number": "833-574-2273"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTOS MARCELO",
"first_name": "MIKAELA",
"middle_name": "FAITH",
"name_prefix": "Mrs.",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-12-06",
"last_updated": "2024-12-06",
"certification_date": "2024-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.