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NPI Code Detail

MEDICARE: SHELLEY FINE LCSW

MEDICARE: SHELLEY FINE LCSW
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
11041C0700XClinical Social Worker19411CA

General Provider Information

NPI Number : 1770793705
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELLEY FINE LCSW
Provider Business Mailing Address
First Line : 5535 BALBOA BLVD STE 202
Second Line :
City : ENCINO
State : CA
Zip : 91316-1541
Country : US
Telephone Number : 818-771-5992
Fax Number : 818-789-5106
Provider Business Practice Location Address
First Line : 5535 BALBOA BLVD STE 202
Second Line :
City : ENCINO
State : CA
Zip : 91316-1541
Country : US
Telephone Number : 818-771-5992
Fax Number : 818-789-5106
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2007
Last Update Date : 07/08/2007

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Directions to “ SHELLEY FINE LCSW” Practice Location

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