Provider Demographics
NPI:1417205386
Name:MAY-SHAH, JESSICA AMBER (MS)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:AMBER
Last Name:MAY-SHAH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1679 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94131-2452
Mailing Address - Country:US
Mailing Address - Phone:415-550-8255
Mailing Address - Fax:415-920-9598
Practice Address - Street 1:1679 CHURCH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94131-2452
Practice Address - Country:US
Practice Address - Phone:415-550-8255
Practice Address - Fax:415-920-9598
Is Sole Proprietor?:No
Enumeration Date:2012-08-26
Last Update Date:2012-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18966235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist