Provider Demographics
NPI:1033415872
Name:SHAFFER, JANE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:
Last Name:SHAFFER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MISS
Other - First Name:JANE
Other - Middle Name:
Other - Last Name:SHAFFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:1580 VISTA ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94602-1746
Mailing Address - Country:US
Mailing Address - Phone:510-530-5334
Mailing Address - Fax:
Practice Address - Street 1:1580 VISTA ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94602-1746
Practice Address - Country:US
Practice Address - Phone:510-530-5334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-26
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25708106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist