Provider Demographics
NPI:1437651684
Name:DUERKSEN, SHAHNA (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:SHAHNA
Middle Name:
Last Name:DUERKSEN
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 BULLARD AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-1057
Mailing Address - Country:US
Mailing Address - Phone:559-323-8484
Mailing Address - Fax:
Practice Address - Street 1:400 BULLARD AVE STE 101
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-1057
Practice Address - Country:US
Practice Address - Phone:559-323-8484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-04
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA140986106H00000X
CA101647106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist