Provider Demographics
NPI:1912102609
Name:SHURMAN, GLORIA MARSHA (PHD)
Entity Type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:MARSHA
Last Name:SHURMAN
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 1:8451 WHALE WATCH WAY
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-2051
Mailing Address - Country:US
Mailing Address - Phone:858-455-7535
Mailing Address - Fax:
Practice Address - Street 1:8451 WHALE WATCH WAY
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-2051
Practice Address - Country:US
Practice Address - Phone:858-455-7535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-20
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY6011103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist