DR. SHELLEY OLIVIA SUTTON M.D. NPI 1942307814

NPI Information

NPI: 1942307814
Provider Name: DR. SHELLEY OLIVIA SUTTON, M.D.
Classification: Psychiatry & Neurology - 2084P0804X
Entity Type: Individual

Specialization: Child & Adolescent Psychiatry

Address:
2045 FAIRMONT DR
SAN LEANDRO, CA
ZIP 94578
Phone: (510) 667-7540
Get Directions

DR. Shelley Olivia Sutton, M.D. is a child and adolescent psychiatry psychiatry neurology in San Leandro, CA. The provider is child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. DR. Shelley Olivia Sutton, M.D. NPI is 1942307814. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2045 FAIRMONT DR
SAN LEANDRO, CA
ZIP 94578-088
Phone: (510) 667-7540

The enumeration date for this NPI number is 9/20/2006 and was last updated on 3/22/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2084P0804X	Psychiatry & Neurology	Child & Adolescent Psychiatry	4301093327	MICHIGAN	No
2	2084P0804X	Psychiatry & Neurology	Child & Adolescent Psychiatry	2003012262	MISSOURI	No
3	2084P0804X	Psychiatry & Neurology	Child & Adolescent Psychiatry	C53616	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	177466	OTHER	MISSOURI	BLUE CROSS BLUE SHIELD
2	208800300	MEDICAID	MISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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