Individual provider Active NPI

Sheila Javadi, OD

  • Optometrist
  • Rancho Cucamonga, CA
National Provider Identifier
1104621093
Registry record updated Feb 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
35913 Issued in CA
Practice address
10740 Foothill Blvd
Rancho Cucamonga, CA 91730-3862
Phone
(909) 942-3030
NPI assigned
Feb 15, 2025
Sex
Female
Sole proprietor
No

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.

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

OrganizationSpecialtyStatusNew patients
National Vision, Inc. PastSince Feb 23, 2025 Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 35913 CA Primary

Addresses

NPPES NPI Registry

Primary practice location

10740 Foothill Blvd
Rancho Cucamonga, CA 91730-3862

Mailing address

PO Box 6021
Fullerton, CA 92834-6021
Phone (714) 765-9595

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 15, 2025.

{
    "created_epoch": "1739577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739577600000",
    "number": "1104621093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6021",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928346021",
            "telephone_number": "714-765-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10740 FOOTHILL BLVD",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303862",
            "telephone_number": "909-942-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAVADI",
        "first_name": "SHEILA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-15",
        "last_updated": "2025-02-15",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "35913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 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.

Verify at the official NPI Registry.