Provider Demographics
NPI:1093014177
Name:BABIOR, SHIRLEY SHERMET (MSW)
Entity type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:SHERMET
Last Name:BABIOR
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 FORT STOCKTON DR
Mailing Address - Street 2:UNIT 114
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-1880
Mailing Address - Country:US
Mailing Address - Phone:619-542-0536
Mailing Address - Fax:619-542-0154
Practice Address - Street 1:3252 HOLIDAY CT
Practice Address - Street 2:220
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-0027
Practice Address - Country:US
Practice Address - Phone:619-542-0536
Practice Address - Fax:619-542-0154
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-15
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALR112301041C0700X
CAMB20760106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMB20760OtherLICENSED MARRIAGE, FAMILY COUNSELOR
CALR11230OtherCALIFORNIA LICENSED CLINICAL SOCIAL WORKER