Individual provider Active NPI

Sabine A Haake, M.A.R.D.

  • Registered Dietitian
  • Corte Madera, CA
National Provider Identifier
1700194545
Registry record updated Sep 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
805457 Issued in CA
Practice address
150 Nellen Ave
Suite 110
Corte Madera, CA 94925-1104
Phone
(415) 924-4457
Fax
(415) 927-4250
NPI assigned
Sep 15, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X
Registered Dietitian 133V00000X 805457 CA Primary

Addresses

Primary practice location

150 Nellen Ave
Suite 110
Corte Madera, CA 94925-1104

Mailing address

331 Tamalpais Dr
Corte Madera, CA 94925-1417
Phone (415) 924-4457

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
805457CAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Fay Nutrition Dietitian, Registered Past Accepting new patients
Mochi Medical Ca PC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1284508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284508800000",
    "number": "1700194545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 TAMALPAIS DR",
            "city": "CORTE MADERA",
            "state": "CA",
            "postal_code": "949251417",
            "telephone_number": "415-924-4457",
            "fax_number": "415-927-4250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 NELLEN AVE",
            "address_2": "SUITE 110",
            "city": "CORTE MADERA",
            "state": "CA",
            "postal_code": "949251104",
            "telephone_number": "415-924-4457",
            "fax_number": "415-927-4250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAAKE",
        "first_name": "SABINE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "M.A.R.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-15",
        "last_updated": "2010-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "805457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corte Madera, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2010; 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.