Provider Demographics
NPI:1376885707
Name:SARTIPY, SHABNAM (MS, CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:SHABNAM
Middle Name:
Last Name:SARTIPY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5874 ZELZAH AVE
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-1023
Mailing Address - Country:US
Mailing Address - Phone:818-482-3684
Mailing Address - Fax:
Practice Address - Street 1:5874 ZELZAH AVE
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-1023
Practice Address - Country:US
Practice Address - Phone:818-482-3684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-24
Last Update Date:2013-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP19903235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist