Individual provider Active NPI

Susan Petraborg Guerard, R.D.

  • Registered Dietitian
  • Bakersfield, CA
National Provider Identifier
1992084560
Registry record updated Aug 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
R511654 Issued in CA
Practice address
1509 McPherson LN
Bakersfield, CA 93311-3571
Phone
(661) 664-9327
Fax
(661) 664-9327
NPI assigned
Aug 12, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X R511654 CA Primary

Addresses

Primary practice location

1509 McPherson LN
Bakersfield, CA 93311-3571

Mailing address

1509 McPherson LN
Bakersfield, CA 93311-3571
Phone (661) 664-9327

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

LicenseStateTypeSpecialty
R511654CAMDRegistered Dietitian

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1313107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313107200000",
    "number": "1992084560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 MCPHERSON LN",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933113571",
            "telephone_number": "661-664-9327",
            "fax_number": "661-664-9327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 MCPHERSON LN",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933113571",
            "telephone_number": "661-664-9327",
            "fax_number": "661-664-9327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERARD",
        "first_name": "SUSAN",
        "middle_name": "PETRABORG",
        "name_prefix": "Mrs.",
        "credential": "R.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-12",
        "last_updated": "2011-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "R511654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2011; 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.