Provider Demographics
NPI:1992180830
Name:CONWAY, SHEA (PSYCHOLOGIST)
Entity type:Individual
Prefix:
First Name:SHEA
Middle Name:
Last Name:CONWAY
Suffix:
Gender:
Credentials:PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2311 I ST APT 7
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-4216
Mailing Address - Country:US
Mailing Address - Phone:530-409-4308
Mailing Address - Fax:
Practice Address - Street 1:2311 I ST APT 7
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-4216
Practice Address - Country:US
Practice Address - Phone:530-409-4308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-21
Last Update Date:2025-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist