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General NPI Number Information
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NPI Number | 1538643234
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Entity Type | Individual
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Provider Name | ANDREW M SHAHAN MA
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Gender | Male
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Dates
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Enumeration Date | 09/18/2018
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Last Update Date | 09/18/2018
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Provider Practice Location Address
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Address Line | 1025 ATLANTIC AVE STE 102
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City | ALAMEDA
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State | CA
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Zip | 94501-1189
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Country | US
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Telephone | 510-268-8120
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Fax |
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Provider Business Mailing Address
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Address Line | 1060 COLE ST APT 7
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City | SAN FRANCISCO
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State | CA
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Zip | 94117-4350
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Country | US
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Telephone | 650-438-0566
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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