Provider Demographics
NPI:1912126350
Name:ADAM-FARAH, SHUKRI YOUSEF (RN, PHN, MHCA)
Entity Type:Individual
Prefix:MRS
First Name:SHUKRI
Middle Name:YOUSEF
Last Name:ADAM-FARAH
Suffix:
Gender:F
Credentials:RN, PHN, MHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3851 ROSECRANS ST
Mailing Address - Street 2:MS P511F
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-3115
Mailing Address - Country:US
Mailing Address - Phone:619-692-8453
Mailing Address - Fax:
Practice Address - Street 1:3896 50TH ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92105
Practice Address - Country:US
Practice Address - Phone:619-757-0441
Practice Address - Fax:619-640-6833
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA584384163WA2000X, 163WC1500X, 163WC1600X, 163WC2100X, 163WH0200X, 163WL0100X, 163WM0102X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WC2100XNursing Service ProvidersRegistered NurseContinence Care
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No374U00000XNursing Service Related ProvidersHome Health Aide