MEDICARE: MRS. APRIL DYANN SHORTERS M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	86971	CA

General Provider Information

NPI Number	:	1033202122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. APRIL DYANN SHORTERS M.S.

Provider Business Mailing Address
First Line	:	7903 ELM AVE
Second Line	:	APARTMENT 34
City	:	RANCHO CUCAMONGA
State	:	CA
Zip	:	91730-8954
Country	:	US
Telephone Number	:	909-486-6107
Fax Number	:

Provider Business Practice Location Address
First Line	:	3125 MYERS ST
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92503-5527
Country	:	US
Telephone Number	:	951-358-3510
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	07/16/2015

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