Shape Your Grape

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

SHAPE YOUR GRAPE

Practice address

728 Cordova Ave
Glendale, CA 91206-2114

Phone

(818) 472-6616

NPI assigned

Jan 11, 2021

Organization subpart

No

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

Authorized official

Name

Rachel J Rodriguez, RDN

Title

Ceo

Phone

(818) 658-1130

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1610323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659657600000",
    "number": "1497344998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N GLENDALE AVE STE B",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912063323",
            "telephone_number": "818-658-1130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "728 CORDOVA AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912062114",
            "telephone_number": "818-472-6616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAPE YOUR GRAPE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-11",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-658-1130",
        "authorized_official_credential": "RDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mohsen Marcus Shamai, PHARM.D.
• Laila Z Shams, D.D.S.
• Nare Shanazary
• Geoffrey Noel Shanklin, D.D.S.
• Shant Kazazian MD Inc.
• Gennady Shapiro, DDS
• Rimma Shaposhnikov, M.D.
• Sanjay Sharma, M.D.
• Shriya Sharma
• Vache Sharyan, PHARMD

• Registered Dietitian in Glendale, CA
• Providers in Glendale, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2022; 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.