Provider Demographics
NPI:1669582227
Name:FELD, SHEVA L (PHD)
Entity type:Individual
Prefix:DR
First Name:SHEVA
Middle Name:L
Last Name:FELD
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 1:44 MOHAWK AVE
Mailing Address - Street 2:
Mailing Address - City:CORTE MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:94925-1033
Mailing Address - Country:US
Mailing Address - Phone:415-924-8496
Mailing Address - Fax:415-924-1707
Practice Address - Street 1:240 TAMAL VISTA BLVD
Practice Address - Street 2:STE 290
Practice Address - City:CORTE MADERA
Practice Address - State:CA
Practice Address - Zip Code:94925
Practice Address - Country:US
Practice Address - Phone:415-924-8496
Practice Address - Fax:415-924-1707
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY12208103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical