Active NPI
Lafeyette Charvuntate Anderson, RDN
- Registered Dietitian
- Norwalk, CA
National Provider Identifier
1972337764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86277928
- Practice address
- 12245 Alondra Blvd Apt 23
Norwalk, CA 90650-6788 - Phone
- (562) 337-2009
- NPI assigned
- Aug 26, 2024
- Last updated
- Aug 26, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Education Nutritionist | 133NN1002X | 86277928 | CA | |
| Registered Dietitian | 133V00000X | 86277928 | CA | Primary |
Addresses
Primary practice location
12245 Alondra Blvd Apt 23
Norwalk, CA 90650-6788
Mailing address
12245 Alondra Blvd Apt 23
Norwalk, CA 90650-6788
Phone (562) 337-2009
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 |
|---|---|---|---|
| 86277928 | CA | MD | Nutrition Education Nutritionist |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724630400000",
"number": "1972337764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12245 ALONDRA BLVD APT 23",
"city": "NORWALK",
"state": "CA",
"postal_code": "906506788",
"telephone_number": "562-337-2009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12245 ALONDRA BLVD APT 23",
"city": "NORWALK",
"state": "CA",
"postal_code": "906506788",
"telephone_number": "562-337-2009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "LAFEYETTE",
"middle_name": "CHARVUNTATE",
"name_prefix": "Mr.",
"credential": "RDN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-08-26",
"last_updated": "2024-08-26",
"certification_date": "2024-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "133NN1002X",
"taxonomy_group": "",
"desc": "Nutritionist, Nutrition, Education",
"state": "CA",
"license": "86277928",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "86277928",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norwalk, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.