Individual
ANI SHAKHVERDYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
8138 FOOTHILL BLVD STE 200, SUNLAND, CA 91040-2900
(818) 579-2248
Mailing address
721 OMAR ST, GLENDALE, CA 91202-2123
(818) 661-8987
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-61066
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
BACB487235
—
CA
Enumeration date
08/25/2022
Last updated
07/29/2024
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