Provider Demographics
NPI:1932234234
Name:BYRNS, SHEILA E (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:E
Last Name:BYRNS
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 1:3120 TELEGRAPH AVE
Mailing Address - Street 2:SUITE 10
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-1965
Mailing Address - Country:US
Mailing Address - Phone:510-649-7979
Mailing Address - Fax:
Practice Address - Street 1:3120 TELEGRAPH AVE
Practice Address - Street 2:SUITE 10
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-1965
Practice Address - Country:US
Practice Address - Phone:510-649-7979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY13608103T00000X
CAMFT15806106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OLP136080Medicare ID - Type Unspecified