Provider Demographics
NPI:1881410991
Name:SHAW, PAMELA (AMFT)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:SHAW
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 S PATTERSON AVE UNIT 6045
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93160-7004
Mailing Address - Country:US
Mailing Address - Phone:805-724-4207
Mailing Address - Fax:
Practice Address - Street 1:615 STATE ST UNIT B
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-3301
Practice Address - Country:US
Practice Address - Phone:805-724-4207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT151542106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist