Provider Demographics
NPI:1649490111
Name:ROSENEAU, SHEILA ELAINE
Entity type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:ELAINE
Last Name:ROSENEAU
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:SHEILA
Other - Middle Name:ELAINE
Other - Last Name:JEFFERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1024
Mailing Address - Street 2:
Mailing Address - City:LUCERNE
Mailing Address - State:CA
Mailing Address - Zip Code:95458-1024
Mailing Address - Country:US
Mailing Address - Phone:707-274-9101
Mailing Address - Fax:707-274-9192
Practice Address - Street 1:6302 THIRTEENTH AVENUE
Practice Address - Street 2:
Practice Address - City:LUCERNE
Practice Address - State:CA
Practice Address - Zip Code:95458-1024
Practice Address - Country:US
Practice Address - Phone:707-274-9101
Practice Address - Fax:707-274-9192
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health