Provider Demographics
NPI:1750044962
Name:PISHNY, SHELBY RENEE
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:RENEE
Last Name:PISHNY
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 1:17727 E CYPRESS ST
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91722-2634
Mailing Address - Country:US
Mailing Address - Phone:626-858-4920
Mailing Address - Fax:626-974-8198
Practice Address - Street 1:17727 E CYPRESS ST
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91722-2634
Practice Address - Country:US
Practice Address - Phone:626-858-4920
Practice Address - Fax:626-974-8198
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-15
Last Update Date:2023-02-22
Deactivation Date:2022-06-15
Deactivation Code:
Reactivation Date:2022-07-19
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171M00000XOther Service ProvidersCase Manager/Care Coordinator