Healthcare Provider Details

I. General information

NPI: 1679832356
Provider Name (Legal Business Name): SHEN ZHAO LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2012
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10176 SADDLEHILL TER
RANCHO CUCAMONGA CA
91737-3069
US

IV. Provider business mailing address

10176 SADDLEHILL TER
RANCHO CUCAMONGA CA
91737-3069
US

V. Phone/Fax

Practice location:
  • Phone: 909-780-3003
  • Fax:
Mailing address:
  • Phone: 909-780-3003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number146261
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: