Provider Demographics
NPI:1932807096
Name:SHIELDS, CLAUDIA O (PHD)
Entity Type:Individual
Prefix:DR
First Name:CLAUDIA
Middle Name:O
Last Name:SHIELDS
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 1:249 E BENWOOD ST
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91722-2814
Mailing Address - Country:US
Mailing Address - Phone:626-393-0446
Mailing Address - Fax:
Practice Address - Street 1:707 WILSHIRE BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-3501
Practice Address - Country:US
Practice Address - Phone:213-452-7320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPY24641103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical