Provider Demographics
NPI:1922776004
Name:AOYAMA, SHANA LOUISA (MA, LMFT)
Entity Type:Individual
Prefix:MS
First Name:SHANA
Middle Name:LOUISA
Last Name:AOYAMA
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6770 STANFORD RANCH RD # 1089
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-1907
Mailing Address - Country:US
Mailing Address - Phone:831-293-7747
Mailing Address - Fax:
Practice Address - Street 1:6770 STANFORD RANCH RD
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-1907
Practice Address - Country:US
Practice Address - Phone:831-293-7747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-02
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA136157106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist