Active NPI
Alyssa Riederman, MS, RDN
- Registered Dietitian
- San Rafael, CA
National Provider Identifier
1922640366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86118730
- Practice address
- 3260 Kerner Blvd
San Rafael, CA 94901-4840 - Phone
- (847) 471-2541
- NPI assigned
- Oct 16, 2019
- 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 | 86118730 | Primary |
Addresses
Primary practice location
3260 Kerner Blvd
San Rafael, CA 94901-4840
Mailing address
1151 6TH St
Berkeley, CA 94710-1200
Phone (847) 471-2541
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | 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": "1571184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571184000000",
"number": "1922640366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1151 6TH ST",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947101200",
"telephone_number": "847-471-2541"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3260 KERNER BLVD",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949014840",
"telephone_number": "847-471-2541"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIEDERMAN",
"first_name": "ALYSSA",
"credential": "MS, RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-10-16",
"last_updated": "2019-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dietitian, Registered",
"state": null,
"license": "86118730",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Rafael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.