| Andrea Shelley, Clinical & Forensic Psychology, A Professional Corpora | |
|
1832 Centro West St Tiburon CA 94920-1909 | |
| (415) 515-3211 | |
| Not Available |
| Full Name | Andrea Shelley, Clinical & Forensic Psychology, A Professional Corpora |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 1832 Centro West St, Tiburon, California |
| Authorized Official Name and Position | Andrea Shelley (PRESIDENT) |
| Authorized Official Contact | 4155153211 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Andrea Shelley, Clinical & Forensic Psychology, A Professional Corpora 1832 Centro West St Tiburon CA 94920-1909 Ph: (415) 515-3211 | Andrea Shelley, Clinical & Forensic Psychology, A Professional Corpora 1832 Centro West St Tiburon CA 94920-1909 Ph: (415) 515-3211 |
| NPI Number | 1568851095 |
|---|---|
| Provider Enumeration Date | 01/21/2015 |
| Last Update Date | 01/21/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568851095 | NPI | - | NPPES |
| HD866A | Other | CA | MEDICARE PART B |
| 113038 | Other | CA | MEDICARE PART B |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY20375 (California) | Primary |
Polly Ely, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 145 Esperanza St, Tiburon, CA 94920 Phone: 415-233-6866 |