MEDICARE: DR. HERBERT SHON PH.D., MSW, 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
1	1041C0700X	Clinical Social Worker	LCSW21933	CA

General Provider Information

NPI Number	:	1851270011
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HERBERT SHON PH.D., MSW, LCSW

Provider Business Mailing Address
First Line	:	745 S MARENGO AVE STE 105
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91106-4738
Country	:	US
Telephone Number	:	323-376-1233
Fax Number	:

Provider Business Practice Location Address
First Line	:	745 S MARENGO AVE STE 105
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91106-4738
Country	:	US
Telephone Number	:	323-376-1233
Fax Number	:

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

Provider Enumeration Date	:	08/30/2025
Last Update Date	:	08/30/2025

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