Active NPI
Heidi Susanne Fennell, DC, FICPA
- Nutrition Chiropractor
- Glendale, CA
National Provider Identifier
1609969120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutrition Chiropractor
- License
- DC29506
- Practice address
- 230 N Maryland Ave Ste 309
Glendale, CA 91206-4281 - Phone
- (818) 549-1300
- Fax
- (818) 549-0075
- NPI assigned
- Oct 2, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Chiropractor | 111NN1001X | DC29506 | CA | Primary |
Addresses
Primary practice location
230 N Maryland Ave Ste 309
Glendale, CA 91206-4281
Mailing address
230 N Maryland Ave Ste 309
Glendale, CA 91206-4281
Phone (818) 549-1300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC29506 | CA | MD | Nutrition Chiropractor |
| 29506 | CA | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556841600000",
"number": "1609969120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "230 N MARYLAND AVE STE 309",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912064281",
"telephone_number": "818-549-1300",
"fax_number": "818-549-0075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "230 N MARYLAND AVE STE 309",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912064281",
"telephone_number": "818-549-1300",
"fax_number": "818-549-0075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FENNELL",
"first_name": "HEIDI",
"middle_name": "SUSANNE",
"name_prefix": "Dr.",
"credential": "DC, FICPA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-02",
"last_updated": "2019-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "111NN1001X",
"taxonomy_group": "",
"desc": "Chiropractor, Nutrition",
"state": "CA",
"license": "DC29506",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.