Doctor Name: | DR. SHELLEY K. SOMMERFELDT |
NPI Number: | 1083759971 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY.D. |
License Number: | PSY22294 |
Business Practice Address: | 934 Hermosa Ave Suite 11 Hermosa Beach, CA - 902544122 |
Business Phone Number: | 3107465929 |
Business Fax Number: | 3103881268 |
Mailing Address: | 934 Hermosa Ave, Suite 11 HERMOSA BEACH |
State: | CA |
Postal Code: | 902544122 |
Phone Number: | 3107465929 |
Fax Number: | 3103881268 |
NPI Enumeration Date: | 02/20/2007 |
NPI Last Update Date: | 09/24/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PSY22294 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |