Provider Demographics
NPI:1922237080
Name:SINCLAIR, SHETONYA
Entity Type:Individual
Prefix:MS
First Name:SHETONYA
Middle Name:
Last Name:SINCLAIR
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:SHETONYA
Other - Middle Name:
Other - Last Name:FORDHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT-INTERN
Mailing Address - Street 1:PO BOX 20482
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90801-3482
Mailing Address - Country:US
Mailing Address - Phone:702-574-1857
Mailing Address - Fax:
Practice Address - Street 1:901 N PACIFIC COAST HWY
Practice Address - Street 2:200A-204A
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-2162
Practice Address - Country:US
Practice Address - Phone:702-574-1857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-10
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65177106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist