Provider Demographics
NPI:1851270318
Name:MASHINCHI, SHABNAM
Entity type:Individual
Prefix:
First Name:SHABNAM
Middle Name:
Last Name:MASHINCHI
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 1:11727 MONTE LEON WAY
Mailing Address - Street 2:
Mailing Address - City:PORTER RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91326-1526
Mailing Address - Country:US
Mailing Address - Phone:818-518-8734
Mailing Address - Fax:
Practice Address - Street 1:16542 VENTURA BLVD STE 320
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-5060
Practice Address - Country:US
Practice Address - Phone:818-452-5534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95378679163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse