Provider Demographics
NPI:1962020271
Name:SHELLEY N OSBORN LIC CLINICAL PSYCHOLOGIST, INC.
Entity Type:Organization
Organization Name:SHELLEY N OSBORN LIC CLINICAL PSYCHOLOGIST, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:OSBORN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:805-963-6500
Mailing Address - Street 1:1515 STATE ST STE 20
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-2536
Mailing Address - Country:US
Mailing Address - Phone:805-963-6500
Mailing Address - Fax:
Practice Address - Street 1:1515 STATE ST STE 20
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2536
Practice Address - Country:US
Practice Address - Phone:805-963-6500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-13
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty