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General NPI Number Information
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NPI Number | 1164802831
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Entity Type | Individual
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Provider Name | DAVID JOHN SHAFFER LMFT
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Gender | Male
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Dates
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Enumeration Date | 06/08/2015
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Last Update Date | 06/08/2015
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Provider Practice Location Address
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Address Line | 100 E THOUSAND OAKS BLVD
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-5713
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Country | US
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Telephone | 805-341-3144
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Fax |
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Provider Business Mailing Address
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Address Line | 3285 HIDDEN CREEK AVE
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-1151
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Country | US
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Telephone | 805-341-3144
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 41933
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License Number State | CA
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