Individual provider Active NPI

Zohreh Shakeri, PA-C

  • Physician Assistant
  • Anaheim, CA
National Provider Identifier
1033269667
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA11847 Issued in CA
Practice address
1211 W la Palma Ave
Suite 207
Anaheim, CA 92801-2815
Phone
(714) 772-8282
Fax
(714) 772-6493
NPI assigned
Jan 12, 2007
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA11847 CA Primary

Addresses

Primary practice location

1211 W la Palma Ave
Suite 207
Anaheim, CA 92801-2815

Mailing address

1211 W la Palma Ave
Suite 207
Anaheim, CA 92801-2815
Phone (714) 772-8282

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
11847CAMDAcupuncturist
PA11847CAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1033269667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 W LA PALMA AVE",
            "address_2": "SUITE 207",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012815",
            "telephone_number": "714-772-8282",
            "fax_number": "714-772-6493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 W LA PALMA AVE",
            "address_2": "SUITE 207",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012815",
            "telephone_number": "714-772-8282",
            "fax_number": "714-772-6493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAKERI",
        "first_name": "ZOHREH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA11847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.