Healthcare Provider Details

I. General information

NPI: 1609143940
Provider Name (Legal Business Name): ELIZABETH SHEA PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2011
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 NAPA VALLEJO HWY
NAPA CA
94558-6234
US

IV. Provider business mailing address

2100 NAPA VALLEJO HWY
NAPA CA
94558-6234
US

V. Phone/Fax

Practice location:
  • Phone: 707-253-5000
  • Fax:
Mailing address:
  • Phone: 707-253-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY32162
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License NumberPSY32162
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: