Provider Demographics
NPI:1740793470
Name:MAHARAJ, SHEENA (MSC/MFT)
Entity Type:Individual
Prefix:MS
First Name:SHEENA
Middle Name:
Last Name:MAHARAJ
Suffix:
Gender:F
Credentials:MSC/MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9008 ELK GROVE BLVD
Mailing Address - Street 2:STE 11
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624
Mailing Address - Country:US
Mailing Address - Phone:916-573-0108
Mailing Address - Fax:
Practice Address - Street 1:9008 ELK GROVE BLVD STE 11
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624
Practice Address - Country:US
Practice Address - Phone:916-573-0108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-16
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF79147106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist