Active NPI
Lawrence Carlyle Headley, RD
- Registered Dietitian
- Hayward, CA
National Provider Identifier
1952804999
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 707397
- Practice address
- 30972 Meadowbrook Ave
Hayward, CA 94544-7544 - Phone
- (954) 655-3696
- Fax
- (510) 400-9095
- NPI assigned
- Mar 15, 2018
- Last updated
- Mar 15, 2018
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 707397 | IL | Primary |
Addresses
Primary practice location
30972 Meadowbrook Ave
Hayward, CA 94544-7544
Mailing address
30972 Meadowbrook Ave
Hayward, CA 94544-7544
Phone (954) 655-3696
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 |
|---|---|---|---|
| 707397 | IL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521072000000",
"number": "1952804999",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30972 MEADOWBROOK AVE",
"city": "HAYWARD",
"state": "CA",
"postal_code": "945447544",
"telephone_number": "954-655-3696",
"fax_number": "510-400-9095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30972 MEADOWBROOK AVE",
"city": "HAYWARD",
"state": "CA",
"postal_code": "945447544",
"telephone_number": "954-655-3696",
"fax_number": "510-400-9095"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEADLEY",
"first_name": "LAWRENCE",
"middle_name": "CARLYLE",
"name_prefix": "Mr.",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-03-15",
"last_updated": "2018-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "707397",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hayward, CA
- Hayward SNF Healthcare, LLC (Hayward Gardens Post Acute)
- Hayward Twin Oaks Montessori
- Hayward Unified School District
- HCRC,Inc
- Mia Headlee
- Health Essentials Resource & Services Inc
- Health Innovations, LP
- Health Now Home Healthcare Inc.
- Healthcare Enterprise LLC (The Medicine Chest Pharmacy)
- Healthnow Hospice Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.