MEDICARE: SHIVANI MUTHUSAMY

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	:	1851240949
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHIVANI MUTHUSAMY

Provider Business Mailing Address
First Line	:	6345 EL CAJON BLVD UNIT 3301
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92115-5573
Country	:	US
Telephone Number	:	323-717-0993
Fax Number	:

Provider Business Practice Location Address
First Line	:	6345 EL CAJON BLVD UNIT 3301
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92115-5573
Country	:	US
Telephone Number	:	323-717-0993
Fax Number	:

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

Provider Enumeration Date	:	01/22/2026
Last Update Date	:	01/22/2026

Similar Medicare Providers

1821017872 — DAVID A SMITH DDS FAGD
Practice Location Address:

5573 SANDBURG AVE
SAN DIEGO, CA
92122

Practice Phone: 858-450-9222
Practice Fax: 858-453-2110

1376268722 — JANA C. ANDERSON BT
Practice Location Address:

5573 BLUERIDGE ST
SAN DIEGO, CA
92139-3404

Practice Phone: 619-603-7164
Practice Fax:

1851371736 — FRANK PAOLANTONIO
Practice Location Address:

6855 SAN MARINO DR APT 210 , SUITE 3950
NAPLES, FL
34108-5573

Practice Phone: 717-817-2505
Practice Fax:

1114016417 — DR. MARIA C VELEZ PASTRANA PH.D.
Practice Location Address:

265 CALLE SIERRA MORENA
SAN JUAN, PR
00926-5573

Practice Phone: 787-547-0513
Practice Fax:

1609902188 — HOLLY HONG LAM MSW
Practice Location Address:

210 N 4TH ST STE 100
SAN JOSE, CA
95112-5573

Practice Phone: 408-295-5288
Practice Fax:

1972786242 — HEATHER HONG
Practice Location Address:

210 N 4TH ST STE 100
SAN JOSE, CA
95112-5573

Practice Phone: 408-295-5288
Practice Fax: 408-292-1029

Directions to “ SHIVANI MUTHUSAMY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.