Provider Demographics
NPI:1164659215
Name:SHEMPER, ADAM D (MA)
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:D
Last Name:SHEMPER
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 PETALUMA BLVD S
Mailing Address - Street 2:#A
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94952-5545
Mailing Address - Country:US
Mailing Address - Phone:707-765-8488
Mailing Address - Fax:
Practice Address - Street 1:1500 PETALUMA BLVD S
Practice Address - Street 2:#A
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94952-5545
Practice Address - Country:US
Practice Address - Phone:415-765-2464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-16
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor