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NPI Code Detail

MEDICARE: MS. SIOUNEH SHABANDARI MSW

MEDICARE:  MS. SIOUNEH  SHABANDARI  MSW
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
1101YM0800XMental Health CounselorASW67654CA
2390200000XStudent in an Organized Health Care Education/Training Program
31041C0700XClinical Social WorkerLCSW90749CA

General Provider Information

NPI Number : 1750792123
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SIOUNEH SHABANDARI MSW
Provider Business Mailing Address
First Line : 237 N CENTRAL AVE
Second Line :
City : GLENDALE
State : CA
Zip : 91203-3526
Country : US
Telephone Number : 818-547-9544
Fax Number : 818-547-9041
Provider Business Practice Location Address
First Line : 237 N CENTRAL AVE
Second Line :
City : GLENDALE
State : CA
Zip : 91203-3526
Country : US
Telephone Number : 818-547-9544
Fax Number : 818-547-9041
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2014
Last Update Date : 01/04/2022

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