MEDICARE: SHEILA NAMIR PH.D.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PSY9304	CA
2	103TP0814X	Psychoanalysis Psychologist	PSY9304	CA
3	103T00000X	Psychologist	PSY9304	CA

General Provider Information

NPI Number	:	1659496024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEILA NAMIR PH.D.

Provider Business Mailing Address
First Line	:	622 ESCALONA DR
Second Line	:
City	:	SANTA CRUZ
State	:	CA
Zip	:	95060-2639
Country	:	US
Telephone Number	:	831-425-5300
Fax Number	:

Provider Business Practice Location Address
First Line	:	725 FRONT ST
Second Line	:	SUITE 200
City	:	SANTA CRUZ
State	:	CA
Zip	:	95060-4538
Country	:	US
Telephone Number	:	831-426-6394
Fax Number	:

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

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	03/12/2014

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Directions to “ SHEILA NAMIR PH.D.” Practice Location

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