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General NPI Number Information
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NPI Number | 1154647345
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Entity Type | Organization
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Legal Business Name | DR ELIZABETH SHON, PSYCHOLOGICAL SERVICES INC.
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Dates
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Enumeration Date | 04/13/2010
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Last Update Date | 04/13/2010
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Provider Practice Location Address
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Address Line | 745 S MARENGO AVE SUITE 105
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City | PASADENA
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State | CA
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Zip | 91106-4735
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Country | US
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Telephone | 626-793-0858
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Fax | 323-256-8203
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Provider Business Mailing Address
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Address Line | 745 S MARENGO AVE SUITE 105
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City | PASADENA
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State | CA
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Zip | 91106-4735
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Country | US
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Telephone | 626-793-0858
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Fax | 323-256-8203
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. ELIZABETH K SHON
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Credential | PH.D
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Telephone | 626-793-0858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY11520
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License Number State | CA
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