Provider Demographics
NPI:1639821879
Name:SUHRBIER, SHAINA I
Entity Type:Individual
Prefix:
First Name:SHAINA
Middle Name:I
Last Name:SUHRBIER
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 1:5473 N SALINAS AVE APT 229
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-6475
Mailing Address - Country:US
Mailing Address - Phone:850-698-1375
Mailing Address - Fax:
Practice Address - Street 1:1752 E BULLARD AVE STE 101
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5864
Practice Address - Country:US
Practice Address - Phone:559-970-8277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-19
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARBT21185372106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA061841803OtherGEORGIA DEPARTMENT OF MOTOR VEHICLES