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Individual

MARK M. SHAW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
1600 CALIFORNIA DR, VACAVILLE, CA 95687
(707) 449-6504
(707) 453-7047
Mailing address
PO BOX 9811, BERKELEY, CA 94709-0811

Taxonomy

Speciality
Code
Description
License number
State
103TF0200X
Forensic Psychologist
Primary
PSY 15079
CA

Other

Enumeration date
05/22/2009
Last updated
05/22/2009
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