Provider Demographics
NPI:1386033009
Name:ASHMORE, SHAYLA JEAN (LMFT)
Entity Type:Individual
Prefix:
First Name:SHAYLA
Middle Name:JEAN
Last Name:ASHMORE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:SHAYLA
Other - Middle Name:JEAN
Other - Last Name:ASHMORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1816 1ST ST
Mailing Address - Street 2:
Mailing Address - City:SUSANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:96130-4561
Mailing Address - Country:US
Mailing Address - Phone:530-310-0572
Mailing Address - Fax:
Practice Address - Street 1:1816 1ST ST
Practice Address - Street 2:
Practice Address - City:SUSANVILLE
Practice Address - State:CA
Practice Address - Zip Code:96130-4561
Practice Address - Country:US
Practice Address - Phone:530-310-0572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-19
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84476106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist