Provider Demographics
NPI:1942722640
Name:SHADROOZ, ANGELA (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:
Last Name:SHADROOZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1144 S ELM DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-1122
Mailing Address - Country:US
Mailing Address - Phone:310-435-9148
Mailing Address - Fax:
Practice Address - Street 1:9171 WILSHIRE BLVD STE 600
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5517
Practice Address - Country:US
Practice Address - Phone:310-435-9148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-13
Last Update Date:2017-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist