MEDICARE: SHIVANI CHANDRA REDDY

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	106S00000X	Behavior Technician		CA

General Provider Information

NPI Number	:	1760357776
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHIVANI CHANDRA REDDY

Provider Business Mailing Address
First Line	:	1333 S MAYFLOWER AVE STE 220
Second Line	:
City	:	MONROVIA
State	:	CA
Zip	:	91016-5239
Country	:	US
Telephone Number	:	818-241-6780
Fax Number	:	888-588-2752

Provider Business Practice Location Address
First Line	:	5250 CLAREMONT AVE STE 142
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95207-5668
Country	:	US
Telephone Number	:	855-295-3276
Fax Number	:	888-588-2752

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

Provider Enumeration Date	:	10/08/2025
Last Update Date	:	10/08/2025

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Directions to “ SHIVANI CHANDRA REDDY ” Practice Location

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