| Doctor Name: | CAROLINA SHAHVERDIYEVA |
| NPI Number: | 1124334917 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | B.A., B.S. |
| License Number: | |
| Business Practice Address: | 957 Industrial Rd Suite B San Carlos, CA - 940704151 |
| Business Phone Number: | 6508326791 |
| Business Fax Number: | 6506209549 |
| Mailing Address: | 957 Industrial Rd, Suite B SAN CARLOS |
| State: | CA |
| Postal Code: | 940704151 |
| Phone Number: | 6508326791 |
| Fax Number: | 6506209549 |
| NPI Enumeration Date: | 08/31/2010 |
| NPI Last Update Date: | 08/13/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |