Active NPI
Suzanne Denise Wimmer, R.D.
- Registered Dietitian
- Antioch, CA
National Provider Identifier
1851447940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 940293
- Practice address
- 4501 Sand Creek Rd
Antioch, CA 94531-8687 - Phone
- (925) 813-7611
- Fax
- (925) 813-7601
- NPI assigned
- Jan 25, 2007
- 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 | 940293 | CA | Primary |
Addresses
Primary practice location
4501 Sand Creek Rd
Antioch, CA 94531-8687
Mailing address
1828 Dixon LN
Concord, CA 94521-2352
Phone (925) 813-7611
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 |
|---|---|---|---|
| 940293 | CA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639526400000",
"number": "1851447940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1828 DIXON LN",
"city": "CONCORD",
"state": "CA",
"postal_code": "945212352",
"telephone_number": "925-813-7611",
"fax_number": "925-813-7601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4501 SAND CREEK RD",
"city": "ANTIOCH",
"state": "CA",
"postal_code": "945318687",
"telephone_number": "925-813-7611",
"fax_number": "925-813-7601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIMMER",
"first_name": "SUZANNE",
"middle_name": "DENISE",
"name_prefix": "Ms.",
"credential": "R.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-25",
"last_updated": "2021-12-15",
"certification_date": "2021-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "940293",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Antioch, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.