Provider Demographics
NPI:1225596315
Name:MCLAUGHLIN, SHELBY MARIE
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:MARIE
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:471 CENTURY PARK DRIVE B
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95961
Mailing Address - Country:US
Mailing Address - Phone:530-329-5233
Mailing Address - Fax:
Practice Address - Street 1:471 CENTURY PARK DRIVE B
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95961
Practice Address - Country:US
Practice Address - Phone:530-329-5233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-07
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAUNKNOWNMedicaid