Individual provider Active NPI

Shabnam Amiri-Dogaheh, M.SC.

  • Speech-Language Pathologist
  • Sherman Oaks, CA
National Provider Identifier
1730637034
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
19639 Issued in CA
Practice address
4533 Vista del Monte Ave Apt 305
Sherman Oaks, CA 91403-3069
Phone
(310) 425-4350
NPI assigned
Sep 14, 2016
Last updated
Aug 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 19639 CA Primary

Addresses

Primary practice location

4533 Vista del Monte Ave Apt 305
Sherman Oaks, CA 91403-3069

Mailing address

4533 Vista del Monte Ave Apt 305
Sherman Oaks, CA 91403-3069
Phone (310) 425-4350

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200513000475 CA Practitioner - Qualified Speech Language Pathologist 4385075050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Speech Plan IncGroup PAC ID 3476984147, 2 clinicians

Practice addresses (Care Compare)

16200 Ventura Blvd
Suite 427
Encino, CA 91436-4914
Phone (818) 746-3395

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Speech Plan Inc Speech-Language Pathologist CurrentSince Feb 10, 2020 Accepting new patients

Locations

16200 Ventura Blvd
Ste 427
Encino, CA 91436
Phone (818) 746-3395

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1473811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1730637034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4533 VISTA DEL MONTE AVE APT 305",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914033069",
            "telephone_number": "310-425-4350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4533 VISTA DEL MONTE AVE APT 305",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914033069",
            "telephone_number": "310-425-4350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMIRI-DOGAHEH",
        "first_name": "SHABNAM",
        "credential": "M.SC.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-14",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "19639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.