Provider Demographics
NPI:1184030264
Name:SHANI, REUT
Entity Type:Individual
Prefix:
First Name:REUT
Middle Name:
Last Name:SHANI
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 1:950 HIGH SCHOOL WAY
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94041-1912
Mailing Address - Country:US
Mailing Address - Phone:408-507-4911
Mailing Address - Fax:
Practice Address - Street 1:950 HIGH SCHOOL WAY
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94041-1912
Practice Address - Country:US
Practice Address - Phone:408-507-4911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health