Active NPI
Gabriella Fahmy
- Registered Dietitian
- San Luis Obispo, CA
National Provider Identifier
1730960477
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86293018
- Practice address
- 3889 Long St Ste 200
San Luis Obispo, CA 93401-7581 - Phone
- (805) 724-6831
- NPI assigned
- Oct 9, 2023
- 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 | 86293018 | CA | Primary |
Addresses
Primary practice location
3889 Long St Ste 200
San Luis Obispo, CA 93401-7581
Mailing address
845 Anchor St
Morro Bay, CA 93442-2303
Phone (805) 539-9018
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 |
|---|---|---|---|
| 86293018 | CA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coastal Integrative Wellness, a Marriage and Family Corp | Current | Accepting new patients | |
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
Locations
3889 Long St
Ste 200
San Luis Obispo, CA 93401
Phone (805) 724-6831
Organizations & group practices 3
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.
-
- Marriage & Family Therapist
- San Luis Obispo, CA
- NPI 1477232932
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1696809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696809600000",
"number": "1730960477",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "845 ANCHOR ST",
"city": "MORRO BAY",
"state": "CA",
"postal_code": "934422303",
"telephone_number": "805-539-9018"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3889 LONG ST STE 200",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934017581",
"telephone_number": "805-724-6831"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAHMY",
"first_name": "GABRIELLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-10-09",
"last_updated": "2023-10-09",
"certification_date": "2023-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "86293018",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Luis Obispo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.