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General NPI Number Information
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NPI Number | 1598813701
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Entity Type | Individual
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Provider Name | BETHYL JOY SHEPPERSON PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 11/27/2019
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Provider Practice Location Address
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Address Line | 1619 E CHAPMAN AVE
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City | FULLERTON
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State | CA
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Zip | 92831-4015
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Country | US
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Telephone | 714-992-4240
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Fax | 714-992-5259
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Provider Business Mailing Address
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Address Line | PO BOX 4938
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City | KAILUA KONA
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State | HI
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Zip | 96745-4938
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Country | US
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Telephone | 808-329-7176
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Fax | 808-326-1279
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY-1717
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License Number State | HI
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