Provider Demographics
NPI:1285719658
Name:O'SHEA, MAUREEN (PHD)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:O'SHEA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 JEFFERSON ST
Mailing Address - Street 2:SUITE 600A
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94559-2442
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1303 JEFFERSON ST
Practice Address - Street 2:SUITE 600A
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-2442
Practice Address - Country:US
Practice Address - Phone:707-258-5800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY12720103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical