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General NPI Number Information
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NPI Number | 1336799642
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Entity Type | Organization
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Legal Business Name | ADVANCED MEP SYSTEMS INC.
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Dates
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Enumeration Date | 09/18/2019
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Last Update Date | 11/21/2022
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Provider Practice Location Address
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Address Line | 44100 MONTEREY AVE STE 216G
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City | PALM DESERT
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State | CA
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Zip | 92260-2718
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Country | US
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Telephone | 310-968-6558
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Fax |
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Provider Business Mailing Address
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Address Line | 44100 MONTEREY AVE STE 216G
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City | PALM DESERT
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State | CA
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Zip | 92260-2718
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Country | US
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Telephone | 310-968-6558
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. SHANA SHAMLOO
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Credential | PSY.D.
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Telephone | 310-968-6558
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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 |
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License Number State |
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