Provider Demographics
NPI:1740209287
Name:SHEPPARD, MARIAN LOUISE (LMFT)
Entity Type:Individual
Prefix:
First Name:MARIAN
Middle Name:LOUISE
Last Name:SHEPPARD
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 1:7801 FOLSOM BOULEVARD
Mailing Address - Street 2:SUITE 214
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826
Mailing Address - Country:US
Mailing Address - Phone:916-806-1530
Mailing Address - Fax:916-429-1530
Practice Address - Street 1:7801 FOLSOM BLVD
Practice Address - Street 2:SUITE 214
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95826-2600
Practice Address - Country:US
Practice Address - Phone:916-806-1530
Practice Address - Fax:916-429-1530
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13332106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist