Provider Demographics
NPI:1487348876
Name:IRANI, SHAHRZAD
Entity type:Individual
Prefix:
First Name:SHAHRZAD
Middle Name:
Last Name:IRANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4656 MONARCH CT
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-7325
Mailing Address - Country:US
Mailing Address - Phone:925-293-6209
Mailing Address - Fax:
Practice Address - Street 1:4656 MONARCH CT
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-7325
Practice Address - Country:US
Practice Address - Phone:925-293-6209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAF05230868363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily