Active NPI
Molly Matthiesen
- Registered Dietitian
- Sacramento, CA
National Provider Identifier
1780250845
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86116895
- Practice address
- 2315 Stockton Blvd
Sacramento, CA 95817-2201 - Phone
- (800) 823-4543
- NPI assigned
- May 31, 2021
- Last updated
- May 31, 2021
- 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 | 86116895 | NU | Primary |
Addresses
Primary practice location
2315 Stockton Blvd
Sacramento, CA 95817-2201
Mailing address
1605 Tilia St Apt 444
Davis, CA 95616-7350
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622419200000",
"number": "1780250845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1605 TILIA ST APT 444",
"city": "DAVIS",
"state": "CA",
"postal_code": "956167350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2315 STOCKTON BLVD",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958172201",
"telephone_number": "800-823-4543"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTHIESEN",
"first_name": "MOLLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-31",
"last_updated": "2021-05-31",
"certification_date": "2021-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NU",
"license": "86116895",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.