Provider Demographics
NPI:1548469844
Name:NOORAVI, SHIRIN (PSYD)
Entity type:Individual
Prefix:DR
First Name:SHIRIN
Middle Name:
Last Name:NOORAVI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18345 VENTURA BLVD STE 314
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-4242
Mailing Address - Country:US
Mailing Address - Phone:818-344-6818
Mailing Address - Fax:818-344-6778
Practice Address - Street 1:18345 VENTURA BLVD STE 314
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-4242
Practice Address - Country:US
Practice Address - Phone:818-344-6818
Practice Address - Fax:818-344-6778
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 21541103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical