Individual provider Active NPI

Heather Shabestari

  • Lactation Consultant (Non-RN)
  • San Diego, CA
National Provider Identifier
1174920011
Registry record updated Jan 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Non-RN)Taxonomy code 174N00000X
License
L59289 Issued in CA
Practice address
6089 Madra Ave
San Diego, CA 92120-3943
Phone
(619) 794-3112
NPI assigned
Nov 20, 2014
Last updated
Jan 13, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Non-RN) 174N00000X L59289 CA Primary

Addresses

Primary practice location

6089 Madra Ave
San Diego, CA 92120-3943

Mailing address

6089 Madra Ave
San Diego, CA 92120-3943
Phone (619) 794-3112

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
L59289CAMDLactation Consultant (Non-RN)

Practice roles

OrganizationSpecialtyStatusNew patients
MCH Ventures, Inc. Lactation Consultant, Non-RN 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": "1416441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421107200000",
    "number": "1174920011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6089 MADRA AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921203943",
            "telephone_number": "619-794-3112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6089 MADRA AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921203943",
            "telephone_number": "619-794-3112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHABESTARI",
        "first_name": "HEATHER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-20",
        "last_updated": "2015-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "CA",
            "license": "L59289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; 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.