Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY14901 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY14901 | CA |
NPI | 1003042763 |
---|---|
Provider Name | Dr. Shama Beth Chaiken |
First Address | Placerville, CA 95667-8668 |
Second Address | Cameron Park, CA 95682-7769 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2009 |
Last Update Date | 01/05/2018 |