Healthcare Provider Details

I. General information

NPI: 1043694953
Provider Name (Legal Business Name): SHEENA EDMONDS MS, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2015
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2105 FOOTHILL BLVD STE B173
LA VERNE CA
91750-2901
US

IV. Provider business mailing address

2105 FOOTHILL BLVD STE B173
LA VERNE CA
91750-2901
US

V. Phone/Fax

Practice location:
  • Phone: 786-838-6388
  • Fax: 562-549-3400
Mailing address:
  • Phone: 562-549-3300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number108999
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMT3914
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: