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General NPI Number Information
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NPI Number | 1215604004
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Entity Type | Organization
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Legal Business Name | SHAVERS MARRIAGE COUPLES AND INDIVIDUAL THERAPY CORPORATION
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Dates
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Enumeration Date | 08/27/2021
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Last Update Date | 01/17/2022
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Provider Practice Location Address
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Address Line | 5408 SILVER CROSSING ST
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City | BAKERSFIELD
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State | CA
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Zip | 93313-4123
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Country | US
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Telephone | 714-584-0361
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Fax |
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Provider Business Mailing Address
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Address Line | 5408 SILVER CROSSING ST
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City | BAKERSFIELD
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State | CA
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Zip | 93313-4123
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LMFT
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Name | CHANELL SHAVERS
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Credential |
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Telephone | 714-584-0361
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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