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General NPI Number Information
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NPI Number | 1922860477
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Entity Type | Individual
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Provider Name | SHAYNE JARVIE BA PSYCHOLOGY
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Gender | Female
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Dates
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Enumeration Date | 01/29/2024
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Last Update Date | 01/29/2024
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Provider Practice Location Address
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Address Line | 3 COMMERCIAL ST
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City | EUREKA
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State | CA
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Zip | 95501-0241
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Country | US
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Telephone | 707-442-2213
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Fax |
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Provider Business Mailing Address
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Address Line | 531 K ST
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City | EUREKA
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State | CA
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Zip | 95501-1146
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Country | US
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Telephone | 707-441-4115
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | CA
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