Provider Demographics
NPI:1366622862
Name:BIRD, SHAUNA BETH (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SHAUNA
Middle Name:BETH
Last Name:BIRD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1792 TRIBUTE RD
Mailing Address - Street 2:350
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95815-4305
Mailing Address - Country:US
Mailing Address - Phone:916-924-6400
Mailing Address - Fax:916-648-0196
Practice Address - Street 1:550 W RANCH VIEW DR
Practice Address - Street 2:3000
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-5396
Practice Address - Country:US
Practice Address - Phone:916-924-6400
Practice Address - Fax:916-648-0196
Is Sole Proprietor?:No
Enumeration Date:2007-11-13
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker