Active NPI
Linda Socorro Davila Herrera, MA, RDN, CD
- Pediatric Nutrition Registered Dietitian
- Salt Lake City, UT
National Provider Identifier
1801587498
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nutrition Registered Dietitian
- License
- 13196633-4901
- Practice address
- 100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103 - Phone
- (801) 662-1000
- NPI assigned
- May 16, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 13196633-4901 | UT | |
| Pediatric Nutrition Registered Dietitian | 133VN1004X | 13196633-4901 | UT | Primary |
Addresses
Primary practice location
100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Mailing address
PO Box 30180
Salt Lake City, UT 84130-0180
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13196633-4901 | UT | MD | Pediatric Nutrition Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730332800000",
"number": "1801587498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 30180",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841300180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 N MARIO CAPECCHI DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841131103",
"telephone_number": "801-662-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVILA HERRERA",
"first_name": "LINDA",
"middle_name": "SOCORRO",
"credential": "MA, RDN, CD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-16",
"last_updated": "2024-10-31",
"certification_date": "2024-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "UT",
"license": "13196633-4901",
"primary": false
},
{
"code": "133VN1004X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Pediatric",
"state": "UT",
"license": "13196633-4901",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.