MEDICARE: DR. GAIL H C SHEN 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	PSY21456	CA

General Provider Information

NPI Number	:	1992903611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GAIL H C SHEN PH.D.

Provider Business Mailing Address
First Line	:	329 S SAN ANTONIO RD STE 7
Second Line	:
City	:	LOS ALTOS
State	:	CA
Zip	:	94022-3637
Country	:	US
Telephone Number	:	650-464-9519
Fax Number	:

Provider Business Practice Location Address
First Line	:	329 S SAN ANTONIO RD STE 7
Second Line	:
City	:	LOS ALTOS
State	:	CA
Zip	:	94022-3637
Country	:	US
Telephone Number	:	650-464-9519
Fax Number	:

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

Provider Enumeration Date	:	07/03/2007
Last Update Date	:	04/05/2023

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