Provider Demographics
NPI:1912352006
Name:SHIRANI, FARINOUSH
Entity Type:Individual
Prefix:
First Name:FARINOUSH
Middle Name:
Last Name:SHIRANI
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 1:1754 W ARROW RTE
Mailing Address - Street 2:APARTMENT 107
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-7659
Mailing Address - Country:US
Mailing Address - Phone:909-358-0333
Mailing Address - Fax:
Practice Address - Street 1:1754 W ARROW RTE
Practice Address - Street 2:APARTMENT 107
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-7659
Practice Address - Country:US
Practice Address - Phone:909-358-0333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-26
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 43440225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist