Provider Demographics
NPI:1922211937
Name:TAUBMAN, SHOSHANA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SHOSHANA
Middle Name:
Last Name:TAUBMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:SHOSHANA
Other - Middle Name:
Other - Last Name:TAUBMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:4316 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94619-2617
Mailing Address - Country:US
Mailing Address - Phone:510-367-2949
Mailing Address - Fax:
Practice Address - Street 1:4 COUNTRY CLUB PLZ STE G
Practice Address - Street 2:
Practice Address - City:ORINDA
Practice Address - State:CA
Practice Address - Zip Code:94563-2308
Practice Address - Country:US
Practice Address - Phone:510-619-8678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21105103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent