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General NPI Number Information
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NPI Number | 1497149876
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Entity Type | Organization
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Legal Business Name | SAN FRANCISCO NEUROPSYCHOLOGY SPECIALISTS
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Dates
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Enumeration Date | 03/24/2015
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Last Update Date | 03/24/2015
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Provider Practice Location Address
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Address Line | 833 MARKET ST SUITE 809
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City | SAN FRANCISCO
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State | CA
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Zip | 94103-1814
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Country | US
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Telephone | 415-627-9095
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Fax | 415-627-9108
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Provider Business Mailing Address
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Address Line | 833 MARKET ST SUITE 809
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City | SAN FRANCISCO
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State | CA
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Zip | 94103-1814
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Country | US
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Telephone | 415-627-9095
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Fax | 415-627-9108
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHELLEY PEERY
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Credential | PHD
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Telephone | 415-218-6915
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 21904
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 21904
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License Number State | CA
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