Provider Demographics
NPI:1841403235
Name:MELKONIAN, SHEYDA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SHEYDA
Middle Name:
Last Name:MELKONIAN
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 1:11526 BAIRD AVE
Mailing Address - Street 2:
Mailing Address - City:PORTER RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91326-1908
Mailing Address - Country:US
Mailing Address - Phone:818-523-9394
Mailing Address - Fax:
Practice Address - Street 1:15233 VENTURA BLVD STE 1208
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-2271
Practice Address - Country:US
Practice Address - Phone:818-523-9394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY21883103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical