Individual provider Active NPI

Lillie Luu Nguyen, LDN, CNS

  • Nutritionist
  • San Francisco, CA
National Provider Identifier
1962038216
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
DX4748 Issued in MD
Practice address
2201 Webster St
San Francisco, CA 94115-1820
Phone
(818) 293-7367
NPI assigned
Mar 19, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X DX4748 MD Primary

Addresses

Primary practice location

2201 Webster St
San Francisco, CA 94115-1820

Mailing address

2460 39TH Ave
San Francisco, CA 94116-2153
Phone (818) 331-7271

Other practice location 1

450 Dondee St
Pacifica, CA 94044-3056
Phone (818) 293-7367

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
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
DX4748MDMDNutritionist

Practice roles

OrganizationSpecialtyStatusNew patients
Starberrie Nutrition Nutritionist CurrentSince Feb 21, 2021 Accepting new patients

Locations

2201 Webster St
San Francisco, CA 94115
Phone (415) 567-8200

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": "1584576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1962038216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2460 39TH AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941162153",
            "telephone_number": "818-331-7271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 WEBSTER ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941151820",
            "telephone_number": "818-293-7367"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 Dondee St",
            "address_purpose": "LOCATION",
            "city": "Pacifica",
            "state": "CA",
            "postal_code": "940443056",
            "country_code": "US",
            "telephone_number": "818-293-7367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "LILLIE",
        "middle_name": "LUU",
        "credential": "LDN, CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-19",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "MD",
            "license": "DX4748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; 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.