Active NPI
Marta Lukas Sovyanhadi
- Registered Dietitian
- Colton, CA
National Provider Identifier
1811582463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 861239
- Practice address
- 2198 Cordillera Ave
Colton, CA 92324-9517 - Phone
- (190) 972-3061
- Fax
- (909) 723-0611
- NPI assigned
- Mar 5, 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 | 861239 | IL | Primary |
Addresses
Primary practice location
2198 Cordillera Ave
Colton, CA 92324-9517
Mailing address
2198 Cordillera Ave
Colton, CA 92324-9517
Phone (190) 972-3061
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 47-1681721 | Other | CA | DIABETES, RENAL, HYPERTENSION AND OTHER LIFE STYLE CHRONIC DISEASES |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 861239 | IL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1614902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614902400000",
"number": "1811582463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2198 CORDILLERA AVE",
"city": "COLTON",
"state": "CA",
"postal_code": "923249517",
"telephone_number": "190-972-3061"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2198 CORDILLERA AVE",
"city": "COLTON",
"state": "CA",
"postal_code": "923249517",
"telephone_number": "190-972-3061",
"fax_number": "909-723-0611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOVYANHADI",
"first_name": "MARTA",
"middle_name": "LUKAS",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-05",
"last_updated": "2021-03-05",
"certification_date": "2021-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "861239",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DIABETES, RENAL, HYPERTENSION AND OTHER LIFE STYLE CHRONIC DISEASES",
"identifier": "47-1681721",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Colton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.