MEDICARE: SHAYNA L HOLLINQUEST

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
1	171M00000X	Case Manager/Care Coordinator
2	225400000X	Rehabilitation Practitioner

General Provider Information

NPI Number	:	1346838398
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAYNA L HOLLINQUEST

Provider Business Mailing Address
First Line	:	12003 AVALON BLVD STE 109
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90061-2859
Country	:	US
Telephone Number	:	323-483-5552
Fax Number	:

Provider Business Practice Location Address
First Line	:	10409 S WESTERN AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90047-4456
Country	:	US
Telephone Number	:	323-315-8232
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2021
Last Update Date	:	05/04/2025

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Directions to “ SHAYNA L HOLLINQUEST ” Practice Location

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