MEDICARE: INTEG ADVANCED NURSING PROFESSIONAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1184573214
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEG ADVANCED NURSING PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	19144 KINGSBURY ST
Second Line	:
City	:	PORTER RANCH
State	:	CA
Zip	:	91326-2943
Country	:	US
Telephone Number	:	818-390-3093
Fax Number	:

Provider Business Practice Location Address
First Line	:	19144 KINGSBURY ST
Second Line	:
City	:	PORTER RANCH
State	:	CA
Zip	:	91326-2943
Country	:	US
Telephone Number	:	818-390-3093
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	SASHA BENTCIANA SHENON
Credential	:	NURSE PRACTITIONER
Telephone Number	:	818-390-3093

Provider Enumeration Date	:	01/22/2026
Last Update Date	:	01/22/2026

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