Provider Demographics
NPI:1063518264
Name:THORPE, SHELBY JEAN (PHD)
Entity type:Individual
Prefix:DR
First Name:SHELBY
Middle Name:JEAN
Last Name:THORPE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:SHELBY
Other - Middle Name:JEAN
Other - Last Name:VANESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13669 SOMERSET RD
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-4034
Mailing Address - Country:US
Mailing Address - Phone:858-229-7004
Mailing Address - Fax:858-748-3232
Practice Address - Street 1:13669 SOMERSET RD
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-4034
Practice Address - Country:US
Practice Address - Phone:858-229-7004
Practice Address - Fax:858-748-3232
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY9611103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP9611Medicare UPIN