Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Shirin Heydari, PA

Individual provider Physician Assistant · NPI 1356977607

Shirin Heydari, PA is a Physician Assistant in Fullerton, California. Graduated from University of Southern California Keck School of Medicine in 2020, 6 years ago. Practices with Providence Medical Foundation, a 1,465-clinician group, accepts Medicare assignment and offers telehealth.

Years since qualifying
6
Trained at
University of Southern California Keck School of Medicine
In the registry since
2020
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

100 E Valencia Mesa Dr Ste 310
Fullerton, CA 92835-3800
Phone: (714) 734-3120
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1356977607
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedMarch 18, 2020
Last updated in NPPESNovember 8, 2021
Certification dateNovember 8, 2021
Mailing address100 E Valencia Mesa Dr Ste 310, Fullerton, CA 92835-3800

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolUNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
Graduated 2020 (6 years in practice)
Group practice Providence Medical Foundation — 1465 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

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