Provider Demographics
NPI:1346608551
Name:TRINCHERO, SHANA (LMFT)
Entity Type:Individual
Prefix:
First Name:SHANA
Middle Name:
Last Name:TRINCHERO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2493
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95063-2493
Mailing Address - Country:US
Mailing Address - Phone:831-223-6791
Mailing Address - Fax:
Practice Address - Street 1:157 VAN NESS AVE
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-4200
Practice Address - Country:US
Practice Address - Phone:831-223-6791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-02
Last Update Date:2018-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF90513106H00000X
CA109528106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist