Provider Demographics
NPI:1174584098
Name:SHAHEEN, RIZWANA (MD)
Entity type:Individual
Prefix:DR
First Name:RIZWANA
Middle Name:
Last Name:SHAHEEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5106 BOULDER CREEK PL
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-3993
Mailing Address - Country:US
Mailing Address - Phone:740-645-5918
Mailing Address - Fax:
Practice Address - Street 1:5106 BOULDER CREEK PL
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93312-3993
Practice Address - Country:US
Practice Address - Phone:740-645-5918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC526152084P0800X, 2084P0804X
OH350816202084P0804X
OH35 0816202084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2460671OtherMEDICARE SH4127241
OH2460671Medicaid
OH2460671Medicaid
OH2460671OtherMEDICARE SH4127241