Active NPI
Shelby Joanna Becker, RD
- Registered Dietitian
- Glendale, CA
National Provider Identifier
1104537018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86154246
- Practice address
- 3472 Roselawn Ave
Glendale, CA 91208-1516 - Phone
- (818) 723-2158
- NPI assigned
- Dec 12, 2022
- 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 | 86154246 | CA | Primary |
Addresses
Primary practice location
3472 Roselawn Ave
Glendale, CA 91208-1516
Mailing address
3472 Roselawn Ave
Glendale, CA 91208-1516
Phone (818) 723-2158
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86154246 | CA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shelby Becker Rd | Dietitian, Registered | Current | Accepting new patients |
| Marjorie Nolan Cohn LLC | Dietitian, Registered | Past | Accepting new patients |
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
Locations
18531 Roscoe Blvd
Ste 200
Northridge, CA 91324
Phone (818) 488-4007
Organizations & group practices 3
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": "1670803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674950400000",
"number": "1104537018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3472 ROSELAWN AVE",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912081516",
"telephone_number": "818-723-2158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3472 ROSELAWN AVE",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912081516",
"telephone_number": "818-723-2158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BECKER",
"first_name": "SHELBY",
"middle_name": "JOANNA",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-12-12",
"last_updated": "2023-01-29",
"certification_date": "2023-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "86154246",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.