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NPI Code Detail

MEDICARE: MS. RHONDA SHEA LMFT

MEDICARE: MS. RHONDA SHEA LMFT
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
1106H00000XMarriage & Family TherapistM25159CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
111707106OTHERCACAQH

General Provider Information

NPI Number : 1255448882
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. RHONDA SHEA LMFT
Provider Business Mailing Address
First Line : 2585 SEBASTOPOL RD UNIT 7716
Second Line :
City : SANTA ROSA
State : CA
Zip : 95407-4630
Country : US
Telephone Number : 707-462-0200
Fax Number :
Provider Business Practice Location Address
First Line : 825 COLLEGE AVE
Second Line :
City : SANTA ROSA
State : CA
Zip : 95404-4108
Country : US
Telephone Number : 707-462-0200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2006
Last Update Date : 02/02/2021

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