Provider Demographics
NPI:1437222817
Name:SHATENI, ELENA K (LAC)
Entity Type:Individual
Prefix:MS
First Name:ELENA
Middle Name:K
Last Name:SHATENI
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 N ORLANDO AVE
Mailing Address - Street 2:SUITE #6
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90048-2529
Mailing Address - Country:US
Mailing Address - Phone:310-210-6393
Mailing Address - Fax:323-782-9620
Practice Address - Street 1:1448 15TH ST STE 105
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2756
Practice Address - Country:US
Practice Address - Phone:310-210-6393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11101171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist