Doctor Name: | SHIRLEY M PICKENS |
NPI Number: | 1003980434 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | MFT7858 |
Business Practice Address: | 8864 Sheldon Oaks Lane Elk Grove, CA - 95624 |
Business Phone Number: | 9164449161 |
Business Fax Number: | 9166820409 |
Mailing Address: | 8864 Sheldon Oaks Ln, ELK GROVE |
State: | CA |
Postal Code: | 956249666 |
Phone Number: | 9164446191 |
Fax Number: | 9166820409 |
NPI Enumeration Date: | 11/18/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | MFT7858 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |