Organization
MARILYN SHORE, PHD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARILYN SHORE PHD (PRESIDENT)
(805) 494-1484
Entity
Organization
Contact information
Practice address
2659 TOWNSGATE RD STE 201, WESTLAKE VILLAGE, CA 91361-2776
(805) 494-1484
(805) 494-9677
Mailing address
2659 TOWNSGATE RD STE 201, WESTLAKE VILLAGE, CA 91361-2776
(805) 494-1484
(805) 494-9677
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PSY118866
PSYCHOLOGIST
CA
Enumeration date
06/24/2019
Last updated
06/24/2019
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