Organization Active NPI

Karine Shakib, Psy.D., a Psychological Corporation

  • Psychologist
  • Encino, CA
National Provider Identifier
1134460025
Registry record updated Mar 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY23343 Issued in CA
Legal business name
KARINE SHAKIB, PSY.D., A PSYCHOLOGICAL CORPORATION
Practice address
16055 Ventura Blvd
Suite 700
Encino, CA 91436-2601
Phone
(818) 903-1972
Fax
(818) 691-0253
NPI assigned
Mar 3, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2013

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

Authorized official

Name
Dr. Karine Shakib, PSY.D.
Title
Clinical Psychologist/Owner
Phone
(818) 903-1972

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X PSY23343 CA Primary

Addresses

Primary practice location

16055 Ventura Blvd
Suite 700
Encino, CA 91436-2601

Mailing address

15021 Ventura Blvd
#406
Sherman Oaks, CA 91403-2442
Phone (818) 903-1972

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130507000103 CA Part B Supplier - Clinic/Group Practice 1052558210 Receives reassigned benefits from 1 practitioner
Practice locations: Encino, CA

National Provider Directory

National Provider Directory

Locations

16055 Ventura Blvd
Ste 645
Encino, CA 91436
Phone (818) 903-1972

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1362268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362268800000",
    "number": "1134460025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15021 VENTURA BLVD",
            "address_2": "#406",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914032442",
            "telephone_number": "818-903-1972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16055 VENTURA BLVD",
            "address_2": "SUITE 700",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362601",
            "telephone_number": "818-903-1972",
            "fax_number": "818-691-0253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KARINE SHAKIB, PSY.D., A PSYCHOLOGICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-03",
        "last_updated": "2013-03-03",
        "status": "A",
        "authorized_official_last_name": "SHAKIB",
        "authorized_official_first_name": "KARINE",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "818-903-1972",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY23343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.