Provider Demographics
NPI:1154456523
Name:SHAKTI, DEBI MORGAN (MA)
Entity Type:Individual
Prefix:
First Name:DEBI
Middle Name:MORGAN
Last Name:SHAKTI
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 33742
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91394-3742
Mailing Address - Country:US
Mailing Address - Phone:818-486-8629
Mailing Address - Fax:
Practice Address - Street 1:18917 NORDHOFF ST
Practice Address - Street 2:SUITE 18
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-3700
Practice Address - Country:US
Practice Address - Phone:818-486-8629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 36581106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist