Provider Demographics
NPI:1992903611
Name:SHEN, GAIL H C (PHD)
Entity type:Individual
Prefix:DR
First Name:GAIL
Middle Name:H C
Last Name:SHEN
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 1:329 S SAN ANTONIO RD STE 7
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-3637
Mailing Address - Country:US
Mailing Address - Phone:650-464-9519
Mailing Address - Fax:
Practice Address - Street 1:329 S SAN ANTONIO RD STE 7
Practice Address - Street 2:
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94022-3637
Practice Address - Country:US
Practice Address - Phone:650-464-9519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY21456103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical