Provider Demographics
NPI:1477633790
Name:VOLKAS, SHOSHANA BELLE (MFT)
Entity Type:Individual
Prefix:MS
First Name:SHOSHANA
Middle Name:BELLE
Last Name:VOLKAS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MS
Other - First Name:SUZANNE
Other - Middle Name:BELLE
Other - Last Name:VOLKAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:22865 WILLARD AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-4031
Mailing Address - Country:US
Mailing Address - Phone:949-581-2222
Mailing Address - Fax:
Practice Address - Street 1:22865 WILLARD AVE
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-4031
Practice Address - Country:US
Practice Address - Phone:949-581-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 31726106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist