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1174483952 NPI number — REGINA ANN LEWIS SHIELDS PH.D. MFT

NPI Number: 1174483952
Health Care Provider/Practitioner: REGINA ANN LEWIS SHIELDS PH.D. MFT

Information about “1174483952” NPI (REGINA ANN LEWIS SHIELDS PH.D. MFT) exists in 1174483952 in HTML format HTML  |  1174483952 in plain Text format TXT  |  1174483952 in PDF (Portable Document Format) PDF  |  1174483952 in an XML format XML  formats.

NPI Number : 1174483952 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1174483952",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "LEWIS SHIELDS",
    "FirstName": "REGINA",
    "MiddleName": "ANN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PH.D. MFT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "SHIELDS",
    "OtherFirstName": "REGINA",
    "OtherMiddleName": "ANN",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "PH.D. MFT",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "5665 COLLEGE AVE",
    "SecondLineMailingAddress": "SUITE 320-C",
    "MailingAddressCityName": "OAKLAND",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "94618",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "510-839-1740",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "5665 COLLEGE AVE",
    "SecondLinePracticeLocationAddress": "SUITE 320-C",
    "PracticeLocationAddressCityName": "OAKLAND",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "94618",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "510-839-1740",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "11/14/2025",
    "LastUpdateDate": "11/14/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "106H00000X",
        "TaxonomyName": "Marriage & Family Therapist",
        "LicenseNumber": "MFC27920",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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