Provider Demographics
NPI:1841586112
Name:MOHEET, SHIRIN (PSYD)
Entity Type:Individual
Prefix:
First Name:SHIRIN
Middle Name:
Last Name:MOHEET
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 1:12100 WILSHIRE BLVD STE 1070
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-7120
Mailing Address - Country:US
Mailing Address - Phone:310-999-5069
Mailing Address - Fax:
Practice Address - Street 1:12100 WILSHIRE BLVD STE 1070
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-7120
Practice Address - Country:US
Practice Address - Phone:310-999-5069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-24
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY27131103T00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist