Carly Heynes, MS, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1095018 Issued in CT

Practice address

620 N Lake Ave
Pasadena, CA 91101-1220

Phone

(626) 793-7350

NPI assigned

Aug 25, 2016

Last updated

Oct 16, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1472083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539648000000",
    "number": "1639625130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 W 91ST ST",
            "address_2": "UNIT B2159",
            "city": "PLAYA DEL REY",
            "state": "CA",
            "postal_code": "902938310",
            "telephone_number": "860-655-9316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 N LAKE AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911011220",
            "telephone_number": "626-793-7350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2716 Ocean Park Blvd Ste 3020",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904055225",
            "country_code": "US",
            "telephone_number": "310-829-9161 x5109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEYNES",
        "first_name": "CARLY",
        "credential": "MS, RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-25",
        "last_updated": "2018-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CT",
            "license": "1095018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2018; 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.