Active NPI
Marlena Katherine Fajardo, DTR
- Registered Dietetic Technician
- Sparks, NV
National Provider Identifier
1952908949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietetic Technician
- Practice address
- 2375 E Prater Way
Sparks, NV 89434-9665 - Phone
- (775) 331-7000
- NPI assigned
- Oct 3, 2020
- 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 Dietetic Technician | 136A00000X | NV | Primary |
Addresses
Primary practice location
2375 E Prater Way
Sparks, NV 89434-9665
Mailing address
4650 Sierra Madre Dr Apt 592
Reno, NV 89502-5529
Phone (530) 906-5445
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601683200000",
"number": "1952908949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4650 SIERRA MADRE DR APT 592",
"city": "RENO",
"state": "NV",
"postal_code": "895025529",
"telephone_number": "530-906-5445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2375 E PRATER WAY",
"city": "SPARKS",
"state": "NV",
"postal_code": "894349665",
"telephone_number": "775-331-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAJARDO",
"first_name": "MARLENA",
"middle_name": "KATHERINE",
"credential": "DTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-03",
"last_updated": "2020-10-03",
"certification_date": "2020-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "136A00000X",
"taxonomy_group": "",
"desc": "Dietetic Technician, Registered",
"state": "NV",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sparks, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.