Provider Demographics
NPI:1245362375
Name:ALBAYALDE, SHALANI (NP)
Entity type:Individual
Prefix:
First Name:SHALANI
Middle Name:
Last Name:ALBAYALDE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12900 PARK PLAZA DR STE 150
Mailing Address - Street 2:ATTN CINDY SPRINGER MS 6135
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-9329
Mailing Address - Country:US
Mailing Address - Phone:562-207-3607
Mailing Address - Fax:562-741-4413
Practice Address - Street 1:12900 PARK PLAZA DR STE 150
Practice Address - Street 2:ATTN CINDY SPRINGER MS 6135
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-9329
Practice Address - Country:US
Practice Address - Phone:562-207-3607
Practice Address - Fax:562-741-4413
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CANP 15282363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANP 15282OtherNURSE PRACTITIONER
CARN 521159OtherREGISTERED NURSE LICENSE
CARN 521159OtherREGISTERED NURSE LICENSE