Individual
JAMSHID SHIVAIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LEP
Contact information
Practice address
333 S BEAUDRY AVE, LOS ANGELES, CA 90017-1466
(310) 241-0615
Mailing address
333 S BEAUDRY AVE, LOS ANGELES, CA 90017-1466
(213) 241-0615
(213) 241-3314
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
2957
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679570980
—
CA
Enumeration date
03/05/2019
Last updated
03/05/2019
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