SHAHLA ALDAVOODI
NPI 1104328384
Nurse Practitioner - Psychiatric/Mental Health in Northridge, CA

Q: What is Shahla Aldavoodi's NPI number?

The NPI number for Shahla Aldavoodi is 1104328384. It was assigned to this individual provider in the NPPES registry on March 5, 2018.

Q: What is Shahla Aldavoodi's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Shahla Aldavoodi was last updated on June 29, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 05, 2018PECOS EnrolledAccepts Medicare Assignment

18300 ROSCOE BLVD, NORTHRIDGE, CA 91325(818) 885-8500 Get Directions Write a Review

NPPES record last updated: June 29, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 3, 2021, Mar 5, 2018 (2 updates tracked since 2018).

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About Shahla Aldavoodi NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHAHLA ALDAVOODI (NPI 1104328384) is an individual psychiatric/mental health provider in Northridge, California, licensed in California (95015696) and active in the NPI registry since March 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1104328384

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameSHAHLA ALDAVOODI

Location Address18300 ROSCOE BLVDNorthridge, CA 91325-4105

Mailing Address19412 Cantara StReseda, CA 91335-1007 · (818) 749-9087

Phone(818) 885-8500

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateMarch 5, 2018

Last NPPES UpdateJune 29, 20222 updates tracked since enumeration

NPPES CertifiedFebruary 3, 2021

✔ NPI 1104328384 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in CA · 95015696

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 95015696 (CA)

18300 ROSCOE BLVD, Northridge, CA 91325

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shahla Aldavoodi is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1052726007

PECOS Enrollment IDI20210224002946

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91325 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JEROME GARY DAVIDSON MD

Internal Medicine (Hematology & Oncology)