Active NPI
Mital Pandya, RD
- Registered Dietitian
- Pleasanton, CA
National Provider Identifier
1891179255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1041746
- Practice address
- 3662 Kamp Dr
Pleasanton, CA 94588-2634 - Phone
- (619) 549-5905
- NPI assigned
- Jul 16, 2015
- 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 | 1041746 | IL | Primary |
Addresses
Primary practice location
3662 Kamp Dr
Pleasanton, CA 94588-2634
Mailing address
3662 Kamp Dr
Pleasanton, CA 94588-2634
Phone (619) 549-5905
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 |
|---|---|---|---|
| 1041746 | IL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437004800000",
"number": "1891179255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3662 KAMP DR",
"city": "PLEASANTON",
"state": "CA",
"postal_code": "945882634",
"telephone_number": "619-549-5905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3662 KAMP DR",
"city": "PLEASANTON",
"state": "CA",
"postal_code": "945882634",
"telephone_number": "619-549-5905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANDYA",
"first_name": "MITAL",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-07-16",
"last_updated": "2015-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "1041746",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pleasanton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.