Individual
SHIRA JAVANFARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LCGC
Contact information
Practice address
13640 ROSCOE BLVD, PANORAMA CITY, CA 91402-3904
(818) 375-2073
(818) 375-3635
Mailing address
1034 23RD ST, SANTA MONICA, CA 90403-4520
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
GC000688
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/16/2015
Last updated
11/23/2021
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