Provider Demographics
NPI:1558579136
Name:SHAKIB-BELTRAN, KARINE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KARINE
Middle Name:
Last Name:SHAKIB-BELTRAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15021 VENTURA BLVD
Mailing Address - Street 2:SUITE 406
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-2442
Mailing Address - Country:US
Mailing Address - Phone:818-903-1972
Mailing Address - Fax:818-691-0253
Practice Address - Street 1:15021 VENTURA BLVD
Practice Address - Street 2:SUITE 406
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-5470
Practice Address - Country:US
Practice Address - Phone:818-903-1972
Practice Address - Fax:818-691-0253
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY23343103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical