Dr Lisa Staab Shadburn, PSYD - Psychologist in South Pasadena, CA

Dr Lisa Staab Shadburn, PSYD is a Psychologist - Clinical based in South Pasadena, California. Dr Lisa Staab Shadburn is licensed to practice in California (license number PSY17173) and her current practice location is 630 Mission St, Suite C2, South Pasadena, California. She can be reached at her office (for appointments etc.) via phone at (626) 403-3040.

NPI number for Dr Lisa Staab Shadburn is 1033233952 and her current mailing address is 1540 E Colorado St, Glendale, California. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1033233952.

Contact Information

Dr Lisa Staab Shadburn, PSYD
630 Mission St, Suite C2,
South Pasadena, CA 91030-3058
(626) 403-3040
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameDr Lisa Staab Shadburn
GenderFemale
SpecialityPsychologist - Clinical
Location630 Mission St, South Pasadena, California
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1033233952
  • Provider Enumeration Date: 03/17/2007
  • Last Update Date: 03/24/2010

Medical Identifiers

Medical identifiers for Dr Lisa Staab Shadburn such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1033233952NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103T00000XPsychologist PSY17173 (California)Secondary
103TC1900XPsychologist - Counseling PSY17173 (California)Secondary
103TC2200XPsychologist - Clinical Child & Adolescent PSY17173 (California)Secondary
103TC0700XPsychologist - Clinical PSY17173 (California)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Lisa Staab Shadburn is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Lisa Staab Shadburn, PSYD
1540 E Colorado St,
Glendale, CA 91205-1514

Ph: (818) 244-7257
Dr Lisa Staab Shadburn, PSYD
630 Mission St, Suite C2,
South Pasadena, CA 91030-3058

Ph: (626) 403-3040

Reviews and Comments


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