Provider Demographics
NPI:1588324834
Name:NAGEL, SHELLEY BARLAS (PHD)
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:BARLAS
Last Name:NAGEL
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 1:1750 TAYLOR ST UNIT 2202
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94133-5441
Mailing Address - Country:US
Mailing Address - Phone:408-497-5589
Mailing Address - Fax:415-913-7516
Practice Address - Street 1:1750 TAYLOR ST UNIT 2202
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94133-5441
Practice Address - Country:US
Practice Address - Phone:408-497-5589
Practice Address - Fax:415-913-7516
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-28
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT8662106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist