Healthcare Provider Details

I. General information

NPI: 1619124484
Provider Name (Legal Business Name): SHEANIA N COLEMAN-DORSEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2008
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6809 INDIANA AVE STE 168
RIVERSIDE CA
92506-4221
US

IV. Provider business mailing address

6809 INDIANA AVE STE 168
RIVERSIDE CA
92506-4221
US

V. Phone/Fax

Practice location:
  • Phone: 909-313-4146
  • Fax:
Mailing address:
  • Phone: 909-313-4146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number119855
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberIMF73998
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: