Brandi Nicole Nicholson, RDN, IBCLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1012432 Issued in CA

Practice address

756 W 108TH St
Los Angeles, CA 90044-4345

Phone

(310) 872-7426

NPI assigned

Apr 21, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1461196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1588018907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "756 W 108TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900444345",
            "telephone_number": "310-872-7426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "756 W 108TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900444345",
            "telephone_number": "310-872-7426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "BRANDI",
        "middle_name": "NICOLE",
        "credential": "RDN, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-21",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "CA",
            "license": "L-301756",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "1012432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marialena Joanne Nichols, R.N.
• Michael Nichols
• Peter W Nichols, MD
• Rodney Dupree Nichols
• Tracy Nichols
• Charles Phifer Nicholson Jr., MD, MTS
• Denise Darcel Nicholson, AU.D.
• Jamie Lee Nicholson
• Kathleen Nicholson
• Lindsey Rachel Nicholson

• Registered Dietitian in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; 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.