Active NPI
Shadi Kashani
- Clinical Psychologist
- Los Angeles, CA
National Provider Identifier
1952513699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 45928
- Practice address
- 12021 Wilshire Blvd Ste 922
Los Angeles, CA 90025-1206 - Phone
- (310) 922-2624
- NPI assigned
- May 4, 2007
- Reactivated
- Jun 29, 2023
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 45928 | CA | Primary |
Addresses
Primary practice location
12021 Wilshire Blvd Ste 922
Los Angeles, CA 90025-1206
Mailing address
12021 Wilshire Blvd Suite 922
Los Angeles, CA 90025
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 45928 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687996800000",
"number": "1952513699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12021 WILSHIRE BLVD SUITE 922",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12021 WILSHIRE BLVD STE 922",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900251206",
"telephone_number": "310-922-2624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KASHANI",
"first_name": "SHADI",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-04",
"last_updated": "2023-06-29",
"certification_date": "2023-06-29",
"deactivation_date": "2013-10-14",
"reactivation_date": "2023-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "45928",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.