Provider Demographics
NPI:1730240052
Name:POUSTI, SHEIVA LENORE (OD)
Entity type:Individual
Prefix:DR
First Name:SHEIVA
Middle Name:LENORE
Last Name:POUSTI
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:7514 GIRARD AVE STE 1231
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-5149
Mailing Address - Country:US
Mailing Address - Phone:858-504-2020
Mailing Address - Fax:
Practice Address - Street 1:3560 FAIRMOUNT AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92105-3420
Practice Address - Country:US
Practice Address - Phone:619-431-2020
Practice Address - Fax:619-376-2100
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA104030T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist