Provider Demographics
NPI:1801978085
Name:SHAH, BARBARA L (NP)
Entity type:Individual
Prefix:
First Name:BARBARA L
Middle Name:
Last Name:SHAH
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:UCI UNIVERSITY NEUROSCIENCES
Mailing Address - Street 2:PO BOX 54778
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90054-0778
Mailing Address - Country:US
Mailing Address - Phone:714-456-6369
Mailing Address - Fax:
Practice Address - Street 1:1701 SOLAR DR STE 140
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030
Practice Address - Country:US
Practice Address - Phone:805-278-4148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00000NP13756363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner