Provider Demographics
NPI:1841437506
Name:SHOTWELL, ALLISON GWYNETH (LMFT)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:GWYNETH
Last Name:SHOTWELL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 CAMBRIDGE AVE STE 19
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-1608
Mailing Address - Country:US
Mailing Address - Phone:650-266-8229
Mailing Address - Fax:
Practice Address - Street 1:2460 17TH AVE # 1009
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-1860
Practice Address - Country:US
Practice Address - Phone:650-229-8156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-15
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA154213106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist