Provider Demographics
NPI:1538885884
Name:SHAFIKHANI, ROMINA
Entity type:Individual
Prefix:
First Name:ROMINA
Middle Name:
Last Name:SHAFIKHANI
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:ROMINA
Other - Middle Name:
Other - Last Name:SHAFIKHANI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:18664 LOREE AVE
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-3838
Mailing Address - Country:US
Mailing Address - Phone:408-966-5334
Mailing Address - Fax:
Practice Address - Street 1:1828 E FLORENCE BLVD STE 102
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-4783
Practice Address - Country:US
Practice Address - Phone:520-510-0360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ32637225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist