Healthcare Provider Details
I. General information
NPI: 1730700899
Provider Name (Legal Business Name): SHIMA ESMAEILI PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/29/2020
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
351 E TEMPLE ST
LOS ANGELES CA
90012-3328
US
IV. Provider business mailing address
4851 HAZELTINE AVE APT 207
SHERMAN OAKS CA
91423-2327
US
V. Phone/Fax
- Phone: 213-253-2677
- Fax:
- Phone: 310-923-8031
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: