Shalaleh Khoei
Individual provider Active NPI Registered Dietitian · Beale Afb, CA
NPI 1407472111 · NPPES record last updated Jun 18, 2020
Key facts
- NPI
- 1407472111
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- DT84068 (TX)
- Practice address
- 15301 Warren Shingle Rd
Beale Afb, CA 95903-1905 - Phone
- (530) 634-4756
- NPI assigned
- Jun 18, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DT84068 | TX | MD | Registered Dietitian |
Interoperability endpoints
- shalaleh.khoei.ctr@mail.mil
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DT84068 | TX | Yes |
Addresses
Primary practice location
15301 Warren Shingle Rd
Beale Afb, CA 95903-1905
Mailing address
15301 Warren Shingle Rd
Beale Afb, CA 95903-1905
Phone (530) 634-4756
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | SHALALEH.KHOEI.CTR@MAIL.MIL |
Other providers in Beale Afb, CA
- Melodee Jackson
- Diane M Janssen
- Alexander Dominic Jobrack
- Melissa G Johnson
- Leonid M. Katkovsky
- Jaehong Kim
- Wanetta King
- David Scott Klajic
- Patricia Ann Knepshield
- Nicolas Lara
All providers in Beale Afb, CA · Registered Dietitian in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 18, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.