Individual
ELENA BALASHOVA-SHAMIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
4712 ADMIRALTY WAY STE 591, MARINA DEL REY, CA 90292-6905
(310) 850-1699
Mailing address
PO BOX 12212, MARINA DEL REY, CA 90295-3212
(310) 486-0404
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY20104
CA
Other
Enumeration date
08/04/2017
Last updated
01/12/2023
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