Nicole Desiree Al-Shafie

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1013062 Issued in CA

Practice address

620 N Brand Blvd Ste 401
Glendale, CA 91203-1210

Phone

(424) 345-2123

NPI assigned

Sep 6, 2017

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

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": "1504656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1780102053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3215 OVERLAND AVE APT 8167",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900344546",
            "telephone_number": "424-345-2123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 N BRAND BLVD STE 401",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912031210",
            "telephone_number": "424-345-2123"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11949 Jefferson Blvd Ste 106",
            "address_purpose": "LOCATION",
            "city": "Culver City",
            "state": "CA",
            "postal_code": "902306336",
            "country_code": "US",
            "telephone_number": "424-345-2123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AL-SHAFIE",
        "first_name": "NICOLE",
        "middle_name": "DESIREE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-06",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "1013062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jihad Shaker Al Imami, M.D.
• Lilian Al Nihmy, DDS
• Farah Al Souheil
• Laila Ann Al-Marayati, M.D.
• Najwan Al-Saiegh, D.C.
• Raniah Al-Talabani
• Ala Hospice and Palliative Care Inc
• Fatmah Ibrahim Alabbad, DO
• Anait Alabyan, DDS
• Vahan Aladadi, RPH

• 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 Mar 17, 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.