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General NPI Number Information
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NPI Number | 1124225370
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Entity Type | Individual
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Provider Name | SHABNAM JESGAR LPC, LPCC
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Gender | Female
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Dates
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Enumeration Date | 06/29/2007
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Last Update Date | 02/21/2020
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Provider Practice Location Address
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Address Line | 812 POLLARD RD STE 6
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City | LOS GATOS
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State | CA
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Zip | 95032-1420
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Country | US
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Telephone | 404-964-4472
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Fax |
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Provider Business Mailing Address
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Address Line | 1608 W CAMPBELL AVE # 243
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City | CAMPBELL
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State | CA
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Zip | 95008-1535
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC005292
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPCC2729
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License Number State | CA
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