Provider Demographics
NPI:1780611137
Name:MAGUEN, SHIRA (PHD)
Entity type:Individual
Prefix:DR
First Name:SHIRA
Middle Name:
Last Name:MAGUEN
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 1:670 FUNSTON AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-3604
Mailing Address - Country:US
Mailing Address - Phone:415-221-4810
Mailing Address - Fax:415-379-5562
Practice Address - Street 1:4150 CLEMENT ST
Practice Address - Street 2:PTSD PROGRAM (116P)
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-1545
Practice Address - Country:US
Practice Address - Phone:415-221-4810
Practice Address - Fax:415-379-5562
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist