MEDICARE: DR. SHIOU-FENG GU

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC1900X	Counseling Psychologist

General Provider Information

NPI Number	:	1407006059
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHIOU-FENG GU

Provider Business Mailing Address
First Line	:	545C PASEO BELLA MONTANA
Second Line	:
City	:	SAN LUIS OBISPO
State	:	CA
Zip	:	93405
Country	:	US
Telephone Number	:	805-439-0696
Fax Number	:

Provider Business Practice Location Address
First Line	:	CALIFORNIA MEN'S COLONY STATE PRISON
Second Line	:
City	:	SAN LUIS OBISPO
State	:	CA
Zip	:	93409-8101
Country	:	US
Telephone Number	:	805-547-7900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2008
Last Update Date	:	09/19/2008

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