Provider Demographics
NPI:1003042763
Name:CHAIKEN, SHAMA BETH (PHD)
Entity type:Individual
Prefix:DR
First Name:SHAMA
Middle Name:BETH
Last Name:CHAIKEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5103 CLARION CT
Mailing Address - Street 2:
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667-8668
Mailing Address - Country:US
Mailing Address - Phone:530-957-4852
Mailing Address - Fax:530-957-4852
Practice Address - Street 1:3330 HEIGHTS DR STE 120
Practice Address - Street 2:
Practice Address - City:CAMERON PARK
Practice Address - State:CA
Practice Address - Zip Code:95682-7769
Practice Address - Country:US
Practice Address - Phone:530-677-4404
Practice Address - Fax:530-677-4545
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-08
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY14901103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical