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NPI Code Detail

MEDICARE: MEGAN SHAINA BAKVA

MEDICARE:   MEGAN SHAINA BAKVA
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
11041C0700XClinical Social Worker114126CA

General Provider Information

NPI Number : 1558148437
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN SHAINA BAKVA
Provider Business Mailing Address
First Line : PO BOX 1572
Second Line :
City : VENICE
State : CA
Zip : 90294-1572
Country : US
Telephone Number : 323-577-4414
Fax Number :
Provider Business Practice Location Address
First Line : 2444 WILSHIRE BLVD STE 508
Second Line :
City : SANTA MONICA
State : CA
Zip : 90403-5826
Country : US
Telephone Number : 415-532-3487
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2023
Last Update Date : 09/13/2023

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Directions to “ MEGAN SHAINA BAKVA ” Practice Location

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