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NPI Code Detail

MEDICARE: MS. SHARILYN RENAE SHAEFFER MFT

MEDICARE: MS. SHARILYN RENAE SHAEFFER MFT
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
1101YM0800XMental Health CounselorIMF54737CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1IMF54737OTHERCAMFT INTERN

General Provider Information

NPI Number : 1558512418
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHARILYN RENAE SHAEFFER MFT
Provider Business Mailing Address
First Line : 9442 JESSICA DR
Second Line :
City : WINDSOR
State : CA
Zip : 95492-8867
Country : US
Telephone Number : 559-960-5704
Fax Number :
Provider Business Practice Location Address
First Line : 2225 CHALLENGER WAY
Second Line :
City : SANTA ROSA
State : CA
Zip : 95407-5441
Country : US
Telephone Number : 707-565-4970
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/08/2008
Last Update Date : 07/21/2022

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