Basic Information
| Provider Information | |||||||||
| NPI: | 1639258163 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TAJII | ||||||||
| FirstName: | SHELVEY | ||||||||
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| Credential: | MSW, LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2323 E PALMDALE BLVD | ||||||||
| Address2: | A | ||||||||
| City: | PALMDALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 935504957 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6612235410 | ||||||||
| FaxNumber: | 6612739357 | ||||||||
| Practice Location | |||||||||
| Address1: | 39959 SIERRA HWY | ||||||||
| Address2: | STE 150 | ||||||||
| City: | PALMDALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 935503313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6612235410 | ||||||||
| FaxNumber: | 6612739357 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/03/2006 | ||||||||
| LastUpdateDate: | 09/11/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 26004 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.