Provider Demographics
NPI:1538593462
Name:CHANDRASEKHARAN, SHEENA (NP)
Entity type:Individual
Prefix:
First Name:SHEENA
Middle Name:
Last Name:CHANDRASEKHARAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8265 W SUNSET BLVD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90046-2429
Mailing Address - Country:US
Mailing Address - Phone:323-375-0950
Mailing Address - Fax:
Practice Address - Street 1:8265 W SUNSET BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90046-2429
Practice Address - Country:US
Practice Address - Phone:323-375-0950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-28
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23049363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily