Active NPI
Alyssa S Bartholomew, MS, RD
- Registered Dietitian
- Glendale, CA
National Provider Identifier
1770066763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86063375
- Practice address
- 1812 Verdugo Blvd
Glendale, CA 91208-1407 - Phone
- (818) 952-3506
- NPI assigned
- Sep 14, 2018
- Last updated
- Sep 14, 2018
- 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 | 86063375 | CA | Primary |
Addresses
Primary practice location
1812 Verdugo Blvd
Glendale, CA 91208-1407
Mailing address
20628 Aetna St
Woodland Hills, CA 91367-5302
Phone (310) 621-7043
Other practice location 1
20628 Aetna Street
206
Woodland, CA 91367
Phone (310) 621-7043
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86063375 | CA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
| Nourish, Inc. | Dietitian, Registered | 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": "1536883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536883200000",
"number": "1770066763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20628 AETNA ST",
"city": "WOODLAND HILLS",
"state": "CA",
"postal_code": "913675302",
"telephone_number": "310-621-7043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1812 VERDUGO BLVD",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912081407",
"telephone_number": "818-952-3506"
}
],
"practiceLocations": [
{
"address_1": "20628 Aetna Street",
"address_2": "206",
"address_purpose": "LOCATION",
"city": "Woodland",
"state": "CA",
"postal_code": "91367",
"country_code": "US",
"telephone_number": "310-621-7043",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BARTHOLOMEW",
"first_name": "ALYSSA",
"middle_name": "S",
"credential": "MS, RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-14",
"last_updated": "2018-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "86063375",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.