Provider Demographics
NPI:1376933226
Name:BRIGGS, SHAWN MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:MARIE
Last Name:BRIGGS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29645 RANCHO CALIFORNIA RD STE 209
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-5285
Mailing Address - Country:US
Mailing Address - Phone:951-693-9800
Mailing Address - Fax:951-693-9801
Practice Address - Street 1:26900 NEWPORT RD STE 112
Practice Address - Street 2:
Practice Address - City:MENIFEE
Practice Address - State:CA
Practice Address - Zip Code:92584-9224
Practice Address - Country:US
Practice Address - Phone:951-489-7418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-30
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW82011101YM0800X
CAASW643641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAASW64364OtherASSOCIATE CLINICAL SOCIAL WORKER REGISTERATION