Provider Demographics
NPI:1629316674
Name:HALPERN, SHELLEY (CHT)
Entity Type:Individual
Prefix:MRS
First Name:SHELLEY
Middle Name:
Last Name:HALPERN
Suffix:
Gender:F
Credentials:CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9356
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91372-9356
Mailing Address - Country:US
Mailing Address - Phone:818-205-7271
Mailing Address - Fax:818-704-8679
Practice Address - Street 1:18226 VENTURA BLVD STE 210
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-4246
Practice Address - Country:US
Practice Address - Phone:818-205-7271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-25
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE0267236OtherDRIVERS LICENSE