MEDICARE: SHANA ANDRUS

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	374J00000X	Doula	01308122	CA

General Provider Information

NPI Number	:	1538987425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANA ANDRUS

Provider Business Mailing Address
First Line	:	221 N 3RD ST
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91502-1202
Country	:	US
Telephone Number	:	702-530-1982
Fax Number	:

Provider Business Practice Location Address
First Line	:	221 N 3RD ST
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91502-1202
Country	:	US
Telephone Number	:	702-530-1982
Fax Number	:

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

Provider Enumeration Date	:	09/30/2024
Last Update Date	:	02/13/2026

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Directions to “ SHANA ANDRUS ” Practice Location

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