Provider Demographics
NPI:1457708182
Name:SHAHINIAN, ADENA (DO)
Entity Type:Individual
Prefix:
First Name:ADENA
Middle Name:
Last Name:SHAHINIAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 S FAIR OAKS AVE STE 325
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-2675
Mailing Address - Country:US
Mailing Address - Phone:626-535-9344
Mailing Address - Fax:626-535-9687
Practice Address - Street 1:625 S FAIR OAKS AVE STE 325
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2675
Practice Address - Country:US
Practice Address - Phone:626-535-9344
Practice Address - Fax:626-535-9687
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSL11962084N0400X
390200000X
CA20A188092084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty