Provider Demographics
NPI:1467805333
Name:TRIGGS, SHELLEY (LMFT)
Entity Type:Individual
Prefix:MS
First Name:SHELLEY
Middle Name:
Last Name:TRIGGS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2575 WILCOMBE DR
Mailing Address - Street 2:
Mailing Address - City:CAMBRIA
Mailing Address - State:CA
Mailing Address - Zip Code:93428-4929
Mailing Address - Country:US
Mailing Address - Phone:805-215-2440
Mailing Address - Fax:805-927-1697
Practice Address - Street 1:1264 HIGUERA ST STE 100
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-3171
Practice Address - Country:US
Practice Address - Phone:805-215-2440
Practice Address - Fax:805-927-1697
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-15
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT91331106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist