Provider Demographics
NPI:1326083916
Name:SHESTER, JUDITH T (LCSW)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:T
Last Name:SHESTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2945 HARDING ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008
Mailing Address - Country:US
Mailing Address - Phone:760-434-4227
Mailing Address - Fax:760-434-2256
Practice Address - Street 1:2945 HARDING ST
Practice Address - Street 2:SUITE 105
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008
Practice Address - Country:US
Practice Address - Phone:760-434-4227
Practice Address - Fax:760-434-2256
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-18
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS62531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAJSSW6253Medicare ID - Type Unspecified
CASW6253Medicare UPIN