Shadab Bahador Jannatipour, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY22662 Issued in CA

Practice address

23504 Lyons Ave Ste 204
Newhall, CA 91321-2534

Phone

(661) 286-2550

NPI assigned

Mar 19, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Shadab Bahador Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• C.B.E.S.T., Inc

  • Early Intervention Provider Agency
  • Los Angeles, CA
  • NPI 1386067361
  NPD (past)
• Center for Behavioral, Educational & Social Therapies

  • Behavior Analyst
  • Los Angeles, CA
  • NPI 1942556378
  NPD (past)

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472428800000",
    "number": "1801911151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11620 WILSHIRE BLVD.",
            "address_2": "STE 450",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90025",
            "telephone_number": "310-445-2378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23504 LYONS AVE STE 204",
            "city": "NEWHALL",
            "state": "CA",
            "postal_code": "913212534",
            "telephone_number": "661-286-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANNATIPOUR",
        "first_name": "SHADAB",
        "middle_name": "BAHADOR",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2016-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY22662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHADAB",
            "last_name": "BAHADOR",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Institute for Functional Health and Nutrition
• International Media Arts Corporation
• Cole Isbell Hampson
• Adam Jacobs
• James R Weagley, MD, Inc.
• Michael C Jean, MD
• Gregory Dean Jenkins, M.D.
• Joanna Zioni, Marriage and Family Therapy, Inc
• John M Scaramella DDS Inc
• JS Wound Care Inc

• Clinical Psychologist in Newhall, CA
• Providers in Newhall, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2016; 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.