Provider Demographics
NPI:1043248669
Name:SHUELL, MICHAEL EDWARD (PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:EDWARD
Last Name:SHUELL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3209 ESPLANADE STE 150
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-0155
Mailing Address - Country:US
Mailing Address - Phone:530-891-6251
Mailing Address - Fax:530-636-4628
Practice Address - Street 1:3209 ESPLANADE STE 150
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-0155
Practice Address - Country:US
Practice Address - Phone:530-891-6292
Practice Address - Fax:530-636-4628
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY19024103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist