Provider Demographics
NPI:1508884677
Name:KAUFFMAN, SHIRLEY OBERST (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHIRLEY
Middle Name:OBERST
Last Name:KAUFFMAN
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 1:28720 CANWOOD ST STE 204
Mailing Address - Street 2:
Mailing Address - City:AGOURA
Mailing Address - State:CA
Mailing Address - Zip Code:91301-4505
Mailing Address - Country:US
Mailing Address - Phone:818-631-6854
Mailing Address - Fax:
Practice Address - Street 1:28720 CANWOOD ST STE 204
Practice Address - Street 2:
Practice Address - City:AGOURA
Practice Address - State:CA
Practice Address - Zip Code:91301-4505
Practice Address - Country:US
Practice Address - Phone:818-631-6854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31579106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist