Active NPI
Stacy Marie Derosa, R.D.
- Metabolic Nutrition Registered Dietitian
- San Francisco, CA
National Provider Identifier
1992135933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Metabolic Nutrition Registered Dietitian
- License
- 1018194
- Practice address
- 355 17TH Ave
San Francisco, CA 94121-2312 - Phone
- (631) 882-5300
- NPI assigned
- Nov 12, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Metabolic Nutrition Registered Dietitian | 133VN1006X | 1018194 | CA | Primary |
Addresses
Primary practice location
355 17TH Ave
San Francisco, CA 94121-2312
Mailing address
355 17TH Ave
San Francisco, CA 94121-2312
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 |
|---|---|---|---|
| 1018194 | CA | MD | Metabolic Nutrition Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | 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.
-
- Registered Dietitian
- San Francisco, CA
- NPI 1104334465
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1384214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761004800000",
"number": "1992135933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "355 17TH AVE",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941212312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "355 17TH AVE",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941212312",
"telephone_number": "631-882-5300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEROSA",
"first_name": "STACY",
"middle_name": "MARIE",
"credential": "R.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-11-12",
"last_updated": "2025-10-21",
"certification_date": "2025-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1006X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Metabolic",
"state": "CA",
"license": "1018194",
"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 Oct 21, 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.