Provider Demographics
NPI:1366874836
Name:LIM, SHAUNA LYNN SMEDLEY
Entity type:Individual
Prefix:
First Name:SHAUNA
Middle Name:LYNN SMEDLEY
Last Name:LIM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHAUNA
Other - Middle Name:LYNN
Other - Last Name:SMEDLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2275 ARLINGTON DR
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94578-1132
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 SANTA BARBARA RD
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-4215
Practice Address - Country:US
Practice Address - Phone:925-256-4118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health