Active NPI
Denise Mathis
- Registered Dietitian
- Roseville, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 850309
- Practice address
- 3100 Douglas Blvd Ste 204
Roseville, CA 95661-3868 - Phone
- (916) 774-8885
- NPI assigned
- Apr 3, 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 | 850309 | CA | Primary |
Addresses
Primary practice location
3100 Douglas Blvd Ste 204
Roseville, CA 95661-3868
Mailing address
PO Box 255228
Sacramento, CA 95865-5228
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
100 Hospital Dr
Vallejo, CA 94589-2580
Phone (707) 551-3600
2702 Low CT
Fairfield, CA 94534-9771
Phone (707) 432-2600
2720 Low CT
Fairfield, CA 94534-9771
Phone (707) 428-2731
2800 L St
Sacramento, CA 95816-5616
3100 Douglas Blvd
Roseville, CA 95661-3866
Phone (916) 774-8500
685 Twelve Bridges Dr
Lincoln, CA 95648-8689
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 850309 | CA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sutter Valley Medical Foundation | Current | Accepting new patients | |
| Sutter Valley Medical Foundation | Current | Accepting new patients | |
| Sutter Valley Medical Foundation | Current | Accepting new patients | |
| Sutter North Medical Foundation | Past | Accepting new patients |
Locations
2720 Low Ct
Fairfield, CA 94534
Phone (707) 428-2731
815 Court St
Ste 7
Jackson, CA 95642
Phone (209) 257-5900
600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755
7 Medical Plaza Dr
Ste 420
Roseville, CA 95661
3100 Douglas Blvd
Roseville, CA 95661
Phone (916) 774-8300
3100 Douglas Blvd
Ste 204
Roseville, CA 95661
Phone (916) 772-7190
2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850
250 W Main St
Woodland, CA 95695
Phone (916) 668-6100
Organizations & group practices 4
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.
-
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- NPI 1669846986
-
- Durable Medical Equipment & Medical Supplies
- Tracy, CA
- NPI 1720930712
-
- Multi-Specialty Clinic/Center
- Sacramento, CA
- NPI 1952327256
-
- Ambulatory Surgical Clinic/Center
- Yuba City, CA
- NPI 1144251521
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685404800000",
"number": "1760187512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 255228",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958655228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 DOUGLAS BLVD STE 204",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "956613868",
"telephone_number": "916-774-8885"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHIS",
"first_name": "DENISE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-03",
"last_updated": "2023-05-30",
"certification_date": "2023-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "850309",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Roseville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.