Provider Demographics
NPI:1861801979
Name:UPSHAW, FRANK (PHD)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:UPSHAW
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3016 MONTGOMERY RD
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-4610
Mailing Address - Country:US
Mailing Address - Phone:530-527-4112
Mailing Address - Fax:
Practice Address - Street 1:3016 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-4610
Practice Address - Country:US
Practice Address - Phone:530-527-4112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-04
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY10746103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical