Dr. Lisa Staab Shadburn
Psychologist Clinical Psychologist Counseling Psychologist Clinical Child & Adolescent Psychologist
630 Mission St Suite C2
South Pasadena
, California 91030-3058
Dr. Lisa Staab Shadburn
Psychologist Clinical Psychologist Counseling Psychologist Clinical Child & Adolescent Psychologist
630 Mission St Suite C2
South Pasadena
, California 91030-3058
(818) 244-7257
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About
Features
Specialties
- Psychologist
- Clinical Psychologist
- Counseling Psychologist
- Clinical Child & Adolescent Psychologist
Languages spoken
- English
Location
First Address
- Dr. Lisa Staab Shadburn
- 1540 E Colorado St
- Glendale, CA
- Zip : 91205-1514
- Phone : (818) 244-7257
Second Address
- Dr. Lisa Staab Shadburn
- 630 Mission St Suite C2
- South Pasadena, CA
- Zip : 91030-3058
- Phone : (626) 403-3040
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 102L00000X | Psychologist | PSY17173 | CA |
| N | 103T00000X | Psychologist | PSY17173 | CA |
| Y | 103G00000X | Clinical Psychologist | PSY17173 | CA |
| Y | 103TC0700X | Clinical Psychologist | PSY17173 | CA |
| N | 103TC1900X | Counseling Psychologist | PSY17173 | CA |
| N | 103TC2200X | Clinical Child & Adolescent Psychologist | PSY17173 | CA |
National Provider Identifier
| NPI | 1033233952 |
|---|---|
| Provider Name | Dr. Lisa Staab Shadburn |
| First Address | Glendale, CA 91205-1514 |
| Second Address | South Pasadena, CA 91030-3058 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 17/03/2007 |
| Last Update Date | 24/03/2010 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.