Active NPI
Shahrzad Fozouni Siassi, PHD
- Psychologist
- Sherman Oaks, CA
National Provider Identifier
1891960944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY10724
- Practice address
- 15206 Ventura Blvd
Suite # 206
Sherman Oaks, CA 91403 - Phone
- (818) 981-2923
- Fax
- (818) 981-2923
- NPI assigned
- Apr 29, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY10724 | CA | Primary |
Addresses
Primary practice location
15206 Ventura Blvd
Suite # 206
Sherman Oaks, CA 91403
Mailing address
15206 Ventura Blvd
Suite 206
Sherman Oaks, CA 91403
Phone (818) 981-2923
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY10724 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346112000000",
"number": "1891960944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15206 VENTURA BLVD",
"address_2": "SUITE 206",
"city": "SHERMAN OAKS",
"state": "CA",
"postal_code": "91403",
"telephone_number": "818-981-2923",
"fax_number": "818-981-2923"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15206 VENTURA BLVD",
"address_2": "SUITE # 206",
"city": "SHERMAN OAKS",
"state": "CA",
"postal_code": "91403",
"telephone_number": "818-981-2923",
"fax_number": "818-981-2923"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIASSI",
"first_name": "SHAHRZAD",
"middle_name": "FOZOUNI",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-29",
"last_updated": "2012-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY10724",
"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 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.