Shir Shanun, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY-25481 Issued in CA

Practice address

174 W Las Flores Ave
Arcadia, CA 91007-8223

Phone

(626) 510-2652

NPI assigned

Jun 23, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2022 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675987200000",
    "number": "1962798389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 W LAS FLORES AVE",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910078223",
            "telephone_number": "626-510-2652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 W LAS FLORES AVE",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910078223",
            "telephone_number": "626-510-2652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANUN",
        "first_name": "SHIR",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-23",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": "CA",
            "license": "WAIVERED PSYCHOLOGIS",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY-25481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shweta Gada Shah, D.P.T.
• Shaun Shahani, D.O
• Rene Yaser Hijjawi Shakhshir, DDS
• Kenneth Leo Shan, MD
• Shannon Bonness MD PC
• Shapiro Stafford Yee & Polonsky PC
• Richard Alan Shapiro, M.D.
• Shapiro, Stafford and Yee Medical
• Sara Sheahan
• Raeesa Sheikh

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.