Provider Demographics
NPI:1306174586
Name:KROMPIER, SHELLEY S (LCSW)
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:S
Last Name:KROMPIER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5401 NORRIS CANYON RD
Mailing Address - Street 2:SUITE 314
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-5409
Mailing Address - Country:US
Mailing Address - Phone:925-947-0823
Mailing Address - Fax:925-277-1724
Practice Address - Street 1:5401 NORRIS CANYON RD
Practice Address - Street 2:SUITE 314
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-5409
Practice Address - Country:US
Practice Address - Phone:925-947-0823
Practice Address - Fax:925-277-1747
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-25
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS123451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical