Active NPI
Stephanie L Congdon, RDN
- Registered Dietitian
- San Diego, CA
National Provider Identifier
1972305571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 13436 El Presidio TRL
San Diego, CA 92130-1419 - Phone
- (619) 400-9583
- NPI assigned
- Mar 25, 2025
- 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 | Primary |
Addresses
Primary practice location
13436 El Presidio TRL
San Diego, CA 92130-1419
Mailing address
13436 El Presidio TRL
San Diego, CA 92130-1419
Phone (619) 400-9583
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
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": "1742860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742860800000",
"number": "1972305571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13436 EL PRESIDIO TRL",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921301419",
"telephone_number": "619-400-9583"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13436 EL PRESIDIO TRL",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921301419",
"telephone_number": "619-400-9583"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONGDON",
"first_name": "STEPHANIE",
"middle_name": "L",
"credential": "RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-03-25",
"last_updated": "2025-03-25",
"certification_date": "2025-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.