Provider Demographics
NPI:1437298700
Name:SHAW, ALICE LOWE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALICE
Middle Name:LOWE
Last Name:SHAW
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 COLE ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-3912
Mailing Address - Country:US
Mailing Address - Phone:415-566-8045
Mailing Address - Fax:415-566-8045
Practice Address - Street 1:134 CLEMENT ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-2420
Practice Address - Country:US
Practice Address - Phone:415-566-8045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY13800103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY138000OtherPSYCHOLOGIST LICENCE NO.
CAPSY138000OtherPSYCHOLOGIST LICENCE NO.