{
"Npi": {
"NPI": "1982336103",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SAHEBGHALAM",
"FirstName": "NIKKI",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "RDN, CNS",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1420 S BUNDY DR APT 403",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LOS ANGELES",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90025-6187",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "818-661-8292",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "201 SPEAR ST STE 1100",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SAN FRANCISCO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "94105-6164",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "415-651-4333",
"PracticeLocationAddressFaxNumber": "844-572-0001",
"EnumerationDate": "06/27/2022",
"LastUpdateDate": "08/21/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "133N00000X",
"TaxonomyName": "Nutritionist",
"LicenseNumber": "18350",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "133V00000X",
"TaxonomyName": "Registered Dietitian",
"LicenseNumber": "86299794",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}