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General NPI Number Information
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NPI Number | 1356407001
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Entity Type | Individual
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Provider Name | SHIRA AMITAI KERI MD
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Gender | Female
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 04/19/2023
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Provider Practice Location Address
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Address Line | 2180 GARNET AVE STE 2E
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City | SAN DIEGO
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State | CA
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Zip | 92109-3675
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Country | US
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Telephone | 858-337-4469
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Fax | 858-777-5555
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Provider Business Mailing Address
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Address Line | 8677 VILLA LA JOLLA DR # 205
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City | LA JOLLA
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State | CA
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Zip | 92037-2354
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Country | US
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Telephone | 858-337-4469
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Fax | 858-777-5555
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A72466
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License Number State | CA
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