Provider Demographics
NPI:1841917960
Name:CONTRERAS, SHAWNA DENISE (RADT1)
Entity type:Individual
Prefix:
First Name:SHAWNA
Middle Name:DENISE
Last Name:CONTRERAS
Suffix:
Gender:F
Credentials:RADT1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-4606
Mailing Address - Country:US
Mailing Address - Phone:559-584-8100
Mailing Address - Fax:
Practice Address - Street 1:410 E 7TH ST
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-4606
Practice Address - Country:US
Practice Address - Phone:559-584-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-20
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR1332571218101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)