Provider Demographics
NPI:1447382726
Name:SHRIKI, CHANNA E (MS)
Entity type:Individual
Prefix:MRS
First Name:CHANNA
Middle Name:E
Last Name:SHRIKI
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:CHANNA
Other - Middle Name:E
Other - Last Name:SHRIKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS
Mailing Address - Street 1:3200 MOTOR AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-3710
Mailing Address - Country:US
Mailing Address - Phone:310-836-1223
Mailing Address - Fax:310-204-4134
Practice Address - Street 1:3200 MOTOR AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-3710
Practice Address - Country:US
Practice Address - Phone:310-836-1223
Practice Address - Fax:310-204-4134
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X, 172V00000X
CA172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional