Provider Demographics
NPI:1124143250
Name:HESLER, SHELLEY A (LCSW)
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:A
Last Name:HESLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SHELLEY
Other - Middle Name:A
Other - Last Name:MABE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1950 ALAMEDA DE LAS PULGAS
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-1222
Mailing Address - Country:US
Mailing Address - Phone:650-573-2302
Mailing Address - Fax:650-349-0771
Practice Address - Street 1:1950 ALAMEDA DE LAS PULGAS
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-1222
Practice Address - Country:US
Practice Address - Phone:650-573-2302
Practice Address - Fax:650-349-0771
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2009-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS191811041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALCS19181OtherCALIFORNIA DEPARTMENT OF CONSUMER AFFAIRS