Provider Demographics
NPI:1043787542
Name:O'CONNOR, SHION W (PSYD)
Entity Type:Individual
Prefix:
First Name:SHION
Middle Name:W
Last Name:O'CONNOR
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 BAYSHORE HWY STE 154
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-1506
Mailing Address - Country:US
Mailing Address - Phone:650-231-2750
Mailing Address - Fax:
Practice Address - Street 1:1601 BAYSHORE HWY STE 154
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-1506
Practice Address - Country:US
Practice Address - Phone:650-231-2750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-01
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist