Individual provider Active NPI

Stephanie Anne Brookshier, RD, CLE

  • Registered Dietitian
  • San Diego, CA
National Provider Identifier
1801117809
Registry record updated Jun 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
00958437 Issued in CA
Practice address
2063 Chatsworth Blvd
San Diego, CA 92107-2731
Phone
(619) 964-8792
NPI assigned
Jun 14, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 00958437 CA Primary

Addresses

Primary practice location

2063 Chatsworth Blvd
San Diego, CA 92107-2731

Mailing address

2063 Chatsworth Blvd
San Diego, CA 92107-2731
Phone (619) 964-8792

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
00958437CAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1276473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276473600000",
    "number": "1801117809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2063 CHATSWORTH BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921072731",
            "telephone_number": "619-964-8792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2063 CHATSWORTH BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921072731",
            "telephone_number": "619-964-8792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKSHIER",
        "first_name": "STEPHANIE",
        "middle_name": "ANNE",
        "credential": "RD, CLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-14",
        "last_updated": "2010-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "00958437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2010; 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.