Provider Demographics
NPI:1588797229
Name:SHIREY, JAMES FRANCIS (LMFT)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:FRANCIS
Last Name:SHIREY
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:DR
Other - First Name:JIM
Other - Middle Name:
Other - Last Name:SHIREY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFT
Mailing Address - Street 1:16519 VICTOR ST
Mailing Address - Street 2:SUITE 406
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-3965
Mailing Address - Country:US
Mailing Address - Phone:909-717-7750
Mailing Address - Fax:760-843-0507
Practice Address - Street 1:16519 VICTOR ST
Practice Address - Street 2:SUITE 406
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-3965
Practice Address - Country:US
Practice Address - Phone:909-717-7750
Practice Address - Fax:760-843-0507
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC28097106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist