Jerry Shafer PHD Inc.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY3395 Issued in CA

Legal business name

JERRY SHAFER PHD INC.

Practice address

3240 Lone Tree Way
#104
Antioch, CA 94509-5559

Phone

(925) 778-1661

Fax

(925) 778-1661

NPI assigned

Jun 29, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jerry Shafer, PHD

Title

Psychologist

Phone

(925) 778-1661

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891723938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3240 LONE TREE WAY",
            "address_2": "#104",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945095559",
            "telephone_number": "925-778-1661",
            "fax_number": "925-778-1661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3240 LONE TREE WAY",
            "address_2": "#104",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945095559",
            "telephone_number": "925-778-1661",
            "fax_number": "925-778-1661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERRY SHAFER PHD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHAFER",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "925-778-1661",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY3395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Erica Jimenez

• Psychologist in Antioch, CA
• Providers in Antioch, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.