Jessica London L. Shaddock in Berkeley - Clinical
Jessica London L. Shaddock - NPI 1700982576
Jessica London L. Shaddock is a Clinical in Berkeley, California. Jessica London L. Shaddock practices all healthcare services and medical treatments related to Clinical. The NPI Number for Jessica London L. Shaddock is 1700982576. The last update date is 2011-01-24.
Jessica London L. Shaddock's current location address is 2704 Mathews St, Berkeley, California. You can contact this provider via phone number 5107176761. The mailing address for Jessica London L. Shaddock is 2704 Mathews St, Berkeley, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jessica London L. Shaddock |
|---|---|
| Address | 2704 Mathews St, Berkeley, California |
| Phone Number | 5107176761 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | PSY.D |
NPI Number Detail
| NPI Number | 1700982576 |
|---|---|
| Provider Enumeration Date | 2006-09-16 |
| Last Updated Date | 2011-01-24 |
Provider Mailing Address Detail
| Address | 2704 Mathews St |
|---|---|
| City | Berkeley |
| State | California (CA) |
| Post Code | 947022216 |
| Phone Number | 5107176761 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | PSY20149 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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What is the unique 10-digit identifier code assigned to Jessica London L. Shaddock by the Centers for Medicare & Medicaid Services?
The Jessica London L. Shaddock has been issued the NPI (National Provider Identifier) 1700982576 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you kindly provide the complete physical address where Jessica London L. Shaddock's facilities are geographically located?
The facilities of Jessica London L. Shaddock are physically situated at the following location: 2704 Mathews St, Berkeley, CA, 947022216.
What is Jessica London L. Shaddock's area of expertise and its corresponding taxonomy classification?
The Jessica London L. Shaddock's field of specialization is Clinical, and it falls under the taxonomy code 103Tc0700X, which categorizes healthcare providers based on their areas of practice.
On what date did Jessica London L. Shaddock receive its 1700982576 assignment from the Centers for Medicare & Medicaid Services?
The Jessica London L. Shaddock was assigned its 1700982576 on 2006-09-16, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the Jessica London L. Shaddock's information last updated?
The Jessica London L. Shaddock's information was last updated on 2011-01-24.