Provider Demographics
NPI:1033515432
Name:ROMERO, SHAINA MARIE
Entity Type:Individual
Prefix:
First Name:SHAINA
Middle Name:MARIE
Last Name:ROMERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 SUN ST
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-3761
Mailing Address - Country:US
Mailing Address - Phone:831-783-3060
Mailing Address - Fax:831-783-3065
Practice Address - Street 1:29 SUN ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-3761
Practice Address - Country:US
Practice Address - Phone:831-783-3060
Practice Address - Fax:831-783-3065
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-12
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA106258106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health