Active NPI
Tracy Daly, MS, RD
- Registered Dietitian
- Poway, CA
National Provider Identifier
1871994905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 863916
- Practice address
- 15525 Pomerado Rd
Suite B-1
Poway, CA 92064-2435 - Phone
- (858) 943-1096
- NPI assigned
- Sep 8, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 | 863916 | CA | Primary |
Addresses
Primary practice location
15525 Pomerado Rd
Suite B-1
Poway, CA 92064-2435
Mailing address
15525 Pomerado Rd
Suite B-1
Poway, CA 92064-2435
Phone (858) 943-1096
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 863916 | Other | CA | CDR 863916 |
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 863916 | CA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410134400000",
"number": "1871994905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15525 POMERADO RD",
"address_2": "SUITE B-1",
"city": "POWAY",
"state": "CA",
"postal_code": "920642435",
"telephone_number": "858-943-1096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15525 POMERADO RD",
"address_2": "SUITE B-1",
"city": "POWAY",
"state": "CA",
"postal_code": "920642435",
"telephone_number": "858-943-1096"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DALY",
"first_name": "TRACY",
"name_prefix": "Ms.",
"credential": "MS, RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-09-08",
"last_updated": "2014-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "863916",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CDR 863916",
"identifier": "863916",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Poway, CA
- Sandra Dalo
- Dalton and Rygg Dental Corporation (Poway Family Dental Group)
- Brittany Dalton
- Cynthia Dalton, RDHAP
- Michael Dalton, DDS
- Ashley Daneker
- Daniel Strub, MD, Inc.
- Darius a Schneider MD Apc (Diabetes and Endocrine Specialists)
- Ayda Dashtaei, D.O.
- David I Bloomberg,OD, a Professional Corporation (Poway Vision Care)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.