Provider Demographics
NPI:1689601734
Name:MUSICANT, SHIRA (MFT, BC-DMT, SEP)
Entity Type:Individual
Prefix:MS
First Name:SHIRA
Middle Name:
Last Name:MUSICANT
Suffix:
Gender:F
Credentials:MFT, BC-DMT, SEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93103-1623
Mailing Address - Country:US
Mailing Address - Phone:805-962-7434
Mailing Address - Fax:805-962-5335
Practice Address - Street 1:26 W MISSION ST
Practice Address - Street 2:SUITE 7
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-0402
Practice Address - Country:US
Practice Address - Phone:805-962-7434
Practice Address - Fax:805-962-5335
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2011-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 20260106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist