Provider Demographics
NPI:1922203934
Name:SINAI, SHIRIN
Entity Type:Individual
Prefix:
First Name:SHIRIN
Middle Name:
Last Name:SINAI
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 1:1453 16TH ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2715
Mailing Address - Country:US
Mailing Address - Phone:310-264-6646
Mailing Address - Fax:
Practice Address - Street 1:1527 4TH ST
Practice Address - Street 2:STE 200
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-2358
Practice Address - Country:US
Practice Address - Phone:310-576-2550
Practice Address - Fax:310-264-6647
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2018-09-26
Deactivation Date:2012-03-01
Deactivation Code:
Reactivation Date:2012-04-13
Provider Licenses
StateLicense IDTaxonomies
CA2012029103TR0400X
101YM0800X
CAPSY27533103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health