Michelle Shalom

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

13675 Issued in CA

Practice address

18350 Mount Langley St
Suite 105
Fountain Valley, CA 92708-6900

Phone

(714) 965-2324

Fax

(714) 965-2684

NPI assigned

May 20, 2011

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

Other names 1

• Michelle Wagner Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: mshalom210059@direct.childrenscolorado.org

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.

• Children'S Hospital Colorado

  • Clinical Social Worker
  • Aurora, CO
  • NPI 1174282776
  NPD
• Childrens Learning Connection, LLC

  • Speech-Language Pathologist
  • Huntington Beach, CA
  • NPI 1689723595

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1305849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377734400000",
    "number": "1811280068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18350 MOUNT LANGLEY ST",
            "address_2": "SUITE 105",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086900",
            "telephone_number": "714-965-2324",
            "fax_number": "714-965-2684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18350 MOUNT LANGLEY ST",
            "address_2": "SUITE 105",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086900",
            "telephone_number": "714-965-2324",
            "fax_number": "714-965-2684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHALOM",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-20",
        "last_updated": "2013-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "13675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "WAGNER",
            "credential": "OTR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nasim Shahbazi, MD
• Shahnaz Qureshi Shaikh MD Inc
• Samah Shaikh
• Shahnaz Qureshi Shaikh, M.D., F.R.C.O.G.
• Mona Ziadeh Shaker, LCSW
• Shamila Leathers MD Inc
• Shane Rayos del Sol, M.D., Inc.
• Ravi Madhure Shankar, M.D.
• Susan Shao, L.AC.
• Stephen Marcel Shapiro, M.D.

• Pediatric Occupational Therapist in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Pediatric Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2013; 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.