Active NPI
Rena Hiedo
- Pharmacist
- La Mesa, CA
National Provider Identifier
1831678762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 77028
- Practice address
- 3749 Avocado Blvd
La Mesa, CA 91941-7301 - Phone
- (619) 760-5335
- Fax
- (619) 670-0159
- NPI assigned
- Aug 10, 2018
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 77028 | CA | Primary |
Addresses
Primary practice location
3749 Avocado Blvd
La Mesa, CA 91941-7301
Mailing address
3749 Avocado Blvd
La Mesa, CA 91941-7301
Phone (619) 760-5335
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
| License | State | Type | Specialty |
|---|---|---|---|
| 77028 | CA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Longs Drug Stores California LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pharmacy
- La Mesa, CA
- NPI 1922041706
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533859200000",
"number": "1831678762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3749 AVOCADO BLVD",
"city": "LA MESA",
"state": "CA",
"postal_code": "919417301",
"telephone_number": "619-760-5335",
"fax_number": "619-670-0159"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3749 AVOCADO BLVD",
"city": "LA MESA",
"state": "CA",
"postal_code": "919417301",
"telephone_number": "619-760-5335",
"fax_number": "619-670-0159"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIEDO",
"first_name": "RENA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-08-10",
"last_updated": "2018-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "77028",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.