Provider Demographics
NPI:1376841098
Name:SHURTER, JOANNE LYNN (MFT)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:LYNN
Last Name:SHURTER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1939 THE ALAMEDA
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-1428
Mailing Address - Country:US
Mailing Address - Phone:408-440-7457
Mailing Address - Fax:408-260-0921
Practice Address - Street 1:1939 THE ALAMEDA
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-1428
Practice Address - Country:US
Practice Address - Phone:408-440-7457
Practice Address - Fax:408-260-0921
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-03
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 49229106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist