Healthcare Provider Details

I. General information

NPI: 1609129436
Provider Name (Legal Business Name): SHONDREA GIL AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHONDREA LETA RECIO

II. Dates (important events)

Enumeration Date: 10/17/2012
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 TRUXTUN AVE
BAKERSFIELD CA
93301-3137
US

IV. Provider business mailing address

PO BOX 1000
BAKERSFIELD CA
93302-1000
US

V. Phone/Fax

Practice location:
  • Phone: 661-868-5000
  • Fax: 661-868-5000
Mailing address:
  • Phone: 661-868-5000
  • Fax: 661-831-2605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number129999
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: