Provider Demographics
NPI:1073049250
Name:SOBRERO, SHAWNA
Entity Type:Individual
Prefix:MRS
First Name:SHAWNA
Middle Name:
Last Name:SOBRERO
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:SHAWNA
Other - Middle Name:
Other - Last Name:SOBRERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1645 CATTLEMEN CT
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-5103
Mailing Address - Country:US
Mailing Address - Phone:760-803-0165
Mailing Address - Fax:
Practice Address - Street 1:1645 CATTLEMEN CT
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-5103
Practice Address - Country:US
Practice Address - Phone:760-803-0165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-07
Last Update Date:2017-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician