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General NPI Number Information
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NPI Number | 1205053873
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Entity Type | Organization
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Legal Business Name | MEGASPAN INC.
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2672 BAYSHORE PKWY SUITE 602
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94043
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Country | US
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Telephone | 650-856-3045
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Fax |
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Provider Business Mailing Address
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Address Line | 744 SEMINOLE WAY
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City | PALO ALTO
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State | CA
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Zip | 94303-4722
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Country | US
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Telephone | 650-856-3045
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. DALIA SHIRAN
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Credential | PH.D.
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Telephone | 650-856-3045
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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 | PSY14463
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License Number State | CA
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