Provider Demographics
NPI:1205097011
Name:MITCHELL, SHELLY LEE (PHD)
Entity type:Individual
Prefix:MS
First Name:SHELLY
Middle Name:LEE
Last Name:MITCHELL
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 1:1601 CONCORD AVE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-9487
Mailing Address - Country:US
Mailing Address - Phone:530-895-5000
Mailing Address - Fax:
Practice Address - Street 1:1601 CONCORD AVE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-9487
Practice Address - Country:US
Practice Address - Phone:530-895-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-24
Last Update Date:2025-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21953103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical