Individual provider Active NPI

Joan Elaine Gates, M.S., M.P.H., R.D.

  • Registered Dietitian
  • Santa Rosa, CA
National Provider Identifier
1801124433
Registry record updated Nov 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
718810 Issued in CA
Practice address
365 Tesconi Cir
Suite B
Santa Rosa, CA 95401-4617
Phone
(707) 575-6043
Fax
(707) 575-1060
NPI assigned
Nov 19, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 718810 CA Primary

Addresses

Primary practice location

365 Tesconi Cir
Suite B
Santa Rosa, CA 95401-4617

Mailing address

365 Tesconi Cir
Suite B
Santa Rosa, CA 95401-4617
Phone (707) 575-6043

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
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1258588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258588800000",
    "number": "1801124433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 TESCONI CIR",
            "address_2": "SUITE B",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014617",
            "telephone_number": "707-575-6043",
            "fax_number": "707-575-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 TESCONI CIR",
            "address_2": "SUITE B",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014617",
            "telephone_number": "707-575-6043",
            "fax_number": "707-575-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATES",
        "first_name": "JOAN",
        "middle_name": "ELAINE",
        "name_prefix": "Ms.",
        "credential": "M.S., M.P.H., R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-19",
        "last_updated": "2009-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "718810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2009; 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.