Nichole Urban, R.D.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1081293 Issued in CA

Practice address

3782 W Martin Luther King Jr Blvd
Los Angeles, CA 90008-1703

Phone

(323) 421-2710

NPI assigned

Dec 1, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Miss Nichole Balandran Former name

Electronic endpoints 1

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": "1417392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1841697208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12135 MITCHELL AVE APT 103",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900664538",
            "telephone_number": "760-218-4489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3782 W MARTIN LUTHER KING JR BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900081703",
            "telephone_number": "323-421-2710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URBAN",
        "first_name": "NICHOLE",
        "name_prefix": "Mrs.",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-01",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "136A00000X",
            "taxonomy_group": "",
            "desc": "Dietetic Technician, Registered",
            "state": "CA",
            "license": "1081293",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "1081293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "6041 Cadillac Ave",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900341702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NICHOLE",
            "last_name": "BALANDRAN",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Urban Connections LLC
• Urban Fit & Therapy Inc.
• Urban Hospice Care Inc
• Jemima Urban Marin
• Urban Med
• Urbanbridge Community Health Services
• Lori Jean Urbanec, R.N., FNP-BC
• Chloe Urbano
• Demelio Alejandro Urbano, MD
• Carmen Navea Urbayan, DNP, RN, CNS

• Registered Dietitian in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2021; 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.