Provider Demographics
NPI:1558592782
Name:TIRSBECK, SHELLEY ANN
Entity Type:Individual
Prefix:
First Name:SHELLEY
Middle Name:ANN
Last Name:TIRSBECK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2131 CAPITOL AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-5755
Mailing Address - Country:US
Mailing Address - Phone:916-529-7874
Mailing Address - Fax:
Practice Address - Street 1:8233 E STOCKTON BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95828-8203
Practice Address - Country:US
Practice Address - Phone:916-368-3080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-05
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health