Individual provider Active NPI

Noor-Hoda Hakimjavadi, MS, RDN

  • Registered Dietitian
  • Woodland Hills, CA
National Provider Identifier
1336604446
Registry record updated Feb 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86023222 Issued in CA
Practice address
22717 Leonora Dr
Woodland Hills, CA 91367-6117
Phone
(310) 402-3765
NPI assigned
Feb 2, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2019

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 86023222 CA Primary

Addresses

Primary practice location

22717 Leonora Dr
Woodland Hills, CA 91367-6117

Mailing address

22717 Leonora Dr
Woodland Hills, CA 91367-6117
Phone (310) 402-3765

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221019003100 CA Practitioner - Registered Dietitian Or Nutrition Professional 3274909098 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
86023222CAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Multi-Specialty Center Inc CurrentSince Aug 1, 2022 Accepting new patients
Southern California Multi-Specialty Center Inc CurrentSince Aug 1, 2022 Accepting new patients
Fay Nutrition Dietitian, Registered Past Accepting new patients

Locations

19950 Rinaldi St
Ste 101D
Porter Ranch, CA 91326
Phone (818) 488-5188

18345 Ventura Blvd
Ste 510
Tarzana, CA 91356
Phone (818) 757-7600

5805 Sepulveda Blvd
Ste 690
Van Nuys, CA 91411
Phone (818) 900-6480

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": "1549065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549065600000",
    "number": "1336604446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22717 LEONORA DR",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913676117",
            "telephone_number": "310-402-3765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22717 LEONORA DR",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913676117",
            "telephone_number": "310-402-3765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAKIMJAVADI",
        "first_name": "NOOR-HODA",
        "name_prefix": "Miss",
        "credential": "MS, RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-02",
        "last_updated": "2019-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "86023222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.