Provider Demographics
NPI:1477583474
Name:ADAMS, SHENEEKRA W
Entity Type:Individual
Prefix:
First Name:SHENEEKRA
Middle Name:W
Last Name:ADAMS
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 1:6060 W OLYMPIC BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-4402
Mailing Address - Country:US
Mailing Address - Phone:323-549-0567
Mailing Address - Fax:323-549-0577
Practice Address - Street 1:6060 W OLYMPIC BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-4402
Practice Address - Country:US
Practice Address - Phone:323-549-0567
Practice Address - Fax:323-549-0577
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU 1843231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWAU1843CMedicare PIN
CAWAU1843AMedicare PIN
CAWAU1843BMedicare PIN