Provider Demographics
NPI:1215713623
Name:SHIVANI SINGH, NO NAME GIVEN
Entity type:Individual
Prefix:MISS
First Name:NO NAME GIVEN
Middle Name:
Last Name:SHIVANI SINGH
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:SHIVANI
Other - Middle Name:
Other - Last Name:S
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:DEPT LA 22763
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91185-2763
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19500 PRUNERIDGE AVE
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-0699
Practice Address - Country:US
Practice Address - Phone:408-228-7328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-01
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician