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General NPI Number Information
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NPI Number | 1598187155
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Entity Type | Individual
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Provider Name | SHELBY MARIE COLBERT
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Gender | Female
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Dates
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Enumeration Date | 01/15/2014
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Last Update Date | 02/21/2019
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Provider Practice Location Address
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Address Line | 237 W MILL ST
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City | SAN BERNARDINO
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State | CA
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Zip | 92408-1403
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Country | US
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Telephone | 909-418-5612
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Fax |
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Provider Business Mailing Address
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Address Line | 237 E MILL STREET
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City | SAN BERNANDIO
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State | CA
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Zip | 92407
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Country | US
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Telephone | 909-388-5600
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 78763
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 111860
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License Number State | CA
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