| Doctor Name: | DR. MICHELE LINDEN SHAW |
| NPI Number: | 1326210659 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ED.D. |
| License Number: | PSY10658 |
| Business Practice Address: | 5955 Lake Vista Dr Bonsall, CA - 920036104 |
| Business Phone Number: | 7604723950 |
| Business Fax Number: | |
| Mailing Address: | 5256 South Mission Road, Suite 703-807 BONSALL |
| State: | CA |
| Postal Code: | 920036104 |
| Phone Number: | 7604723950 |
| Fax Number: | 7604723949 |
| NPI Enumeration Date: | 03/26/2008 |
| NPI Last Update Date: | 05/24/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PSY10658 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |