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General NPI Number Information
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NPI Number | 1265937064
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Entity Type | Organization
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Legal Business Name | DR. JENNIFER SHAPIRO, PHD
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Dates
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Enumeration Date | 03/26/2018
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Last Update Date | 04/17/2023
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Provider Practice Location Address
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Address Line | 3525 DEL MAR HEIGHTS RD STE 1952
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City | SAN DIEGO
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State | CA
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Zip | 92130-2199
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Country | US
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Telephone | 619-825-0499
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Fax | 888-551-6358
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Provider Business Mailing Address
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Address Line | 3525 DEL MAR HEIGHTS RD STE 1952
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City | SAN DIEGO
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State | CA
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Zip | 92130-2199
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Country | US
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Telephone | 619-825-0499
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Fax | 888-551-6358
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Authorized Official
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Title or Position | LICENSED CLINICAL PSYCHOLOGIST
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Name | JENNIFER SHAPIRO
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Credential | PH. D
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Telephone | 619-825-0499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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