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NPI Code Detail

MEDICARE: YASAMAN SHAKERANEH

MEDICARE: YASAMAN SHAKERANEH
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
1363A00000XPhysician AssistantPA67740CA

General Provider Information

NPI Number : 1093541435
Entity Type Code : Individual
Provider Name (Legal Business Name) : YASAMAN SHAKERANEH
Provider Business Mailing Address
First Line : 28082 PINNACLES CT
Second Line :
City : LAGUNA NIGUEL
State : CA
Zip : 92677-7019
Country : US
Telephone Number : 949-933-2321
Fax Number :
Provider Business Practice Location Address
First Line : 113 WATERWORKS WAY STE 155
Second Line :
City : IRVINE
State : CA
Zip : 92618-3163
Country : US
Telephone Number : 949-612-9090
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2024
Last Update Date : 04/14/2026

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Directions to “ YASAMAN SHAKERANEH ” Practice Location

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