Provider Demographics
NPI:1699925925
Name:KARABAN, SHALEA
Entity type:Individual
Prefix:
First Name:SHALEA
Middle Name:
Last Name:KARABAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 S AMPHLETT BLVD
Mailing Address - Street 2:SUITE 314
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94402-2703
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1710 S AMPHLETT BLVD
Practice Address - Street 2:SUITE 314
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94402-2703
Practice Address - Country:US
Practice Address - Phone:650-742-0179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-23
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101Y00000XBehavioral Health & Social Service ProvidersCounselor