Candice Rebecca Shadgoo, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT296925 Issued in CA

Practice address

11611 San Vicente Blvd Ste L1
Los Angeles, CA 90049-6534

Phone

(310) 820-0013

NPI assigned

Aug 4, 2026

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1785801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1366366338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11907 CHAPARAL ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900492909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11611 SAN VICENTE BLVD STE L1",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900496534",
            "telephone_number": "310-820-0013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADGOO",
        "first_name": "CANDICE",
        "middle_name": "REBECCA",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-04",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT296925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nasima Diana Shadbehr, D.O
• Vivien Talosig Shadd, MSN, FNP-BC,CDE
• Tali Shaddaei, CCC-SLP
• Trevor Shaddox, MD, PHD
• Pamela L Shade, CRNA
• Shadi Medical Corporation
• Ashkan Rafael Shadi, LMFT
• Jonathan R. Shadi, D.D.S.
• Payam Shadi, M.D.
• Shadle Chiropractic Prof. Corp.

• Physical Therapist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2026; 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.