Provider Demographics
NPI:1518443597
Name:ATANUS, SHAROKEENA
Entity type:Individual
Prefix:
First Name:SHAROKEENA
Middle Name:
Last Name:ATANUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15030 VENTURA BLVD STE 11
Mailing Address - Street 2:P.O. BOX 383
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-2491
Mailing Address - Country:US
Mailing Address - Phone:209-678-8710
Mailing Address - Fax:
Practice Address - Street 1:15030 VENTURA BLVD #11
Practice Address - Street 2:P.O. BOX #383
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-2491
Practice Address - Country:US
Practice Address - Phone:209-678-8710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-13
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty