Healthcare Provider Details

I. General information

NPI: 1114459419
Provider Name (Legal Business Name): SHELBY BRIANNE STRALEY LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2017
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8989 RIO SAN DIEGO DR STE 200
SAN DIEGO CA
92108-1647
US

IV. Provider business mailing address

8989 RIO SAN DIEGO DR STE 200
SAN DIEGO CA
92108-1647
US

V. Phone/Fax

Practice location:
  • Phone: 858-279-1223
  • Fax: 858-467-7161
Mailing address:
  • Phone: 858-279-1223
  • Fax: 858-467-7161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number19695
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: