Provider Demographics
NPI:1295844173
Name:SHINOZAKI, MARSHA KAZUKO (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARSHA
Middle Name:KAZUKO
Last Name:SHINOZAKI
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5080 E PELTIER RD
Mailing Address - Street 2:
Mailing Address - City:ACAMPO
Mailing Address - State:CA
Mailing Address - Zip Code:95220-9633
Mailing Address - Country:US
Mailing Address - Phone:916-412-5726
Mailing Address - Fax:
Practice Address - Street 1:8788 ELK GROVE BLVD
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-1766
Practice Address - Country:US
Practice Address - Phone:916-714-6060
Practice Address - Fax:916-714-6067
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA281721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical