Provider Demographics
NPI:1316474018
Name:AKTAN, SHAINA MARIE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:SHAINA
Middle Name:MARIE
Last Name:AKTAN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:SHAINA
Other - Middle Name:MARIE
Other - Last Name:MCCOLLUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7373 UNIVERSITY AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-0524
Mailing Address - Country:US
Mailing Address - Phone:619-333-0434
Mailing Address - Fax:
Practice Address - Street 1:7373 UNIVERSITY AVE STE 202
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-0524
Practice Address - Country:US
Practice Address - Phone:619-333-0434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-12
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35433235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist