Provider Demographics
NPI:1902023518
Name:SHRYER, WILLIAM JON (MSW, LCSW, DCSW)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:JON
Last Name:SHRYER
Suffix:
Gender:M
Credentials:MSW, LCSW, DCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1613
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-6613
Mailing Address - Country:US
Mailing Address - Phone:925-648-4800
Mailing Address - Fax:925-648-2530
Practice Address - Street 1:4185 BLACKHAWK PLAZA CIRCLE
Practice Address - Street 2:SUITE 210
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94506-4964
Practice Address - Country:US
Practice Address - Phone:925-648-4800
Practice Address - Fax:945-648-2530
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 99421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALCS 9942OtherSTATE LICENSE