Organization Active NPI

Nutriviva Inc

  • Registered Dietitian
  • San Jose, CA
National Provider Identifier
1679066419
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1053627 Issued in CA
Legal business name
NUTRIVIVA INC
Practice address
3535 Ross Ave
San Jose, CA 95124-3054
Phone
(408) 212-7877
Fax
(408) 212-7882
NPI assigned
Jun 6, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Authorized official

Name
Ms. Shraddha Patel, MS RDN
Title
Consulting Dietitian
Phone
(408) 212-7877

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X 1053627 CA Primary

Addresses

Primary practice location

3535 Ross Ave
San Jose, CA 95124-3054

Mailing address

3535 Ross Ave
San Jose, CA 95124-3054
Phone (408) 212-7877

Other names 1

  • NUTRIVIVA.INC Doing business as

National Provider Directory

National Provider Directory

Locations

3535 Ross Ave
San Jose, CA 95124
Phone (408) 212-7877

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1528243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730160000000",
    "number": "1679066419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 ROSS AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951243054",
            "telephone_number": "408-212-7877",
            "fax_number": "408-212-7882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 ROSS AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951243054",
            "telephone_number": "408-212-7877",
            "fax_number": "408-212-7882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUTRIVIVA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-06",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "SHRADDHA",
        "authorized_official_title_or_position": "CONSULTING DIETITIAN",
        "authorized_official_telephone_number": "408-212-7877",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS RDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "1053627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NUTRIVIVA.INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.