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General NPI Number Information
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NPI Number | 1134460025
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Entity Type | Organization
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Legal Business Name | KARINE SHAKIB, PSY.D., A PSYCHOLOGICAL CORPORATION
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Dates
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Enumeration Date | 03/03/2013
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Last Update Date | 03/03/2013
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Provider Practice Location Address
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Address Line | 16055 VENTURA BLVD SUITE 700
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City | ENCINO
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State | CA
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Zip | 91436-2601
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Country | US
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Telephone | 818-903-1972
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Fax | 818-691-0253
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Provider Business Mailing Address
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Address Line | 15021 VENTURA BLVD #406
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-2442
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Country | US
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Telephone | 818-903-1972
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST/OWNER
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Name | DR. KARINE SHAKIB
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Credential | PSY.D.
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Telephone | 818-903-1972
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY23343
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License Number State | CA
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