Provider Demographics
NPI:1407038318
Name:SHAW, SARA F (MFT)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:F
Last Name:SHAW
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1980 WASHINGTON ST APT 106
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-2930
Mailing Address - Country:US
Mailing Address - Phone:415-250-6289
Mailing Address - Fax:
Practice Address - Street 1:1980 WASHINGTON ST APT 106
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-2930
Practice Address - Country:US
Practice Address - Phone:415-250-6289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43586106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist