MEDICARE: SHIR ZION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	103TB0200X	Cognitive & Behavioral Psychologist
2	103TH0004X	Health Psychologist
3	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1588359202
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHIR ZION

Provider Business Mailing Address
First Line	:	200 WEST ARBOR DRIVE
Second Line	:	0737
City	:	SAN DIEGO
State	:	CA
Zip	:	92103
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 WEST ARBOR DRIVE
Second Line	:	0737
City	:	SAN DIEGO
State	:	CA
Zip	:	92103
Country	:	US
Telephone Number	:	818-807-4041
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2023
Last Update Date	:	04/07/2023

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Directions to “ SHIR ZION ” Practice Location

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