Provider Demographics
NPI:1457866238
Name:MARSHALL-MCLEAN, SHELIA COLLETTE
Entity Type:Individual
Prefix:
First Name:SHELIA
Middle Name:COLLETTE
Last Name:MARSHALL-MCLEAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2994
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92878-2994
Mailing Address - Country:US
Mailing Address - Phone:951-742-7561
Mailing Address - Fax:951-742-7563
Practice Address - Street 1:5729 VISTA DEL CABALLERO
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92509-6423
Practice Address - Country:US
Practice Address - Phone:951-742-7561
Practice Address - Fax:951-742-7563
Is Sole Proprietor?:No
Enumeration Date:2017-12-03
Last Update Date:2017-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT20221106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist