Carolyn B. Shadduck PH.D., PSY.D.

NPI 1891710125 - Psychologist - 103TC0700X

NPI Details
NPI 1891710125
Gender Female
Enumeration Date 07/13/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 11 years ago
Practice Location
636 26TH ST
SANTA MONICA CA, 90402-3148, US
Phone (310) 395-0436
Fax (310) 395-1887
Business Location
636 26TH ST
SANTA MONICA CA, 90402-3148, US
Phone (310) 395-0436
Fax (310) 395-1887
Toxanomy
Taxonomy Code 103TC0700X
License State California
License Number PSY4871
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According to our database, Dr. Carolyn B. Shadduck PH.D., PSY.D. NPI is 1891710125, taxonomy code is 103TC0700X and license number is PSY4871, license state is located at California. Carolyn B. Shadduck PH.D., PSY.D. physically located at 636 26th St, Santa Monica CA, 90402-3148. NPI Number Carolyn B. Shadduck PH.D., PSY.D. has the Individual type.

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1891710125 NPI number is provided on an as is basis without warranty of any kind. 1891710125 is maintained by the National Plan & Provider Enumeration System. The contents of Carolyn B. Shadduck PH.D., PSY.D. are for informational purposes only.