Healthcare Provider Details

I. General information

NPI: 1497051205
Provider Name (Legal Business Name): VICTORIA SHUTS LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2011
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3009 HUBBARD LN
EUREKA CA
95501-4800
US

IV. Provider business mailing address

4271 LIBERTY BELL CT
EUREKA CA
95503-8912
US

V. Phone/Fax

Practice location:
  • Phone: 707-267-5372
  • Fax:
Mailing address:
  • Phone: 707-267-5372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFTI64899
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: