Heather Macbrair, RD

Primary specialty

SpecialistTaxonomy code 174400000X

License

RD972811 Issued in CA

Practice address

6215 Feral Ave
Agoura Hills, CA 91301-1756

Phone

(818) 540-8269

NPI assigned

Jan 29, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Heather Modesti Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Nourish, Inc.

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  • NPI 1558097824
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1264723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422230400000",
    "number": "1447581566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6215 FERAL AVE",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913011756",
            "telephone_number": "818-540-8269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6215 FERAL AVE",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913011756",
            "telephone_number": "818-540-8269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACBRAIR",
        "first_name": "HEATHER",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-29",
        "last_updated": "2015-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "RD972811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "MODESTI",
            "credential": "RD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Ajay Malhotra, PH.D.
• Malibu California Model Drug Treatment Center, Inc
• Malibu California Model Drug Treatment Center,Inc

• Specialist in Agoura Hills, CA
• Providers in Agoura Hills, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.