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General NPI Number Information
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NPI Number | 1679500565
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Entity Type | Individual
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Provider Name | SHIRLEY LAURINE DICKINSON M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 2930 2ND AVE STE 200
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City | MARINA
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State | CA
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Zip | 93933-6244
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Country | US
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Telephone | 831-582-2100
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Fax |
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Provider Business Mailing Address
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Address Line | 100 WILSON RD STE 100
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City | MONTEREY
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State | CA
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Zip | 93940-7885
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Country | US
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Telephone | 831-649-1000
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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 | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | G56281
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G56281
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License Number State | CA
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