Provider Demographics
NPI:1376853101
Name:SHAKHGELDYAN, ANNA
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:SHAKHGELDYAN
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 1:5232 VENTURA CANYON AVE
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-5921
Mailing Address - Country:US
Mailing Address - Phone:818-822-3434
Mailing Address - Fax:
Practice Address - Street 1:541 W COLORADO ST
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-3638
Practice Address - Country:US
Practice Address - Phone:818-822-3434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-14
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)