Individual provider Active NPI

Jessica Sherwood, RD

  • Registered Dietitian
  • Santa Rosa, CA
National Provider Identifier
1881959740
Registry record updated Aug 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1084421 Issued in CA
Practice address
3883 Airway Dr
Santa Rosa, CA 95403-1670
Phone
(707) 521-8939
Fax
(707) 573-5427
NPI assigned
Jul 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2020

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 1084421 CA Primary

Addresses

Primary practice location

3883 Airway Dr
Santa Rosa, CA 95403-1670

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408
Phone (707) 521-8939

Other practice location 1

365 Walker Dr Apt B
Mountain View, CA 94043-2109
Phone (408) 903-3632

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

State licenses

LicenseStateTypeSpecialty
1084421CAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1341532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1881959740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "707-521-8939",
            "fax_number": "707-873-5427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3883 AIRWAY DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031670",
            "telephone_number": "707-521-8939",
            "fax_number": "707-573-5427"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "365 Walker Dr Apt B",
            "address_purpose": "LOCATION",
            "city": "Mountain View",
            "state": "CA",
            "postal_code": "940432109",
            "country_code": "US",
            "telephone_number": "408-903-3632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHERWOOD",
        "first_name": "JESSICA",
        "name_prefix": "Miss",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-06",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "1084421",
            "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 Aug 28, 2020; 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.