Provider Demographics
NPI:1881237394
Name:ROSSI-SHEWAN, CLORINDA (LMFT)
Entity type:Individual
Prefix:
First Name:CLORINDA
Middle Name:
Last Name:ROSSI-SHEWAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 5TH ST APT 14
Mailing Address - Street 2:
Mailing Address - City:SOLVANG
Mailing Address - State:CA
Mailing Address - Zip Code:93463-2741
Mailing Address - Country:US
Mailing Address - Phone:310-562-9886
Mailing Address - Fax:
Practice Address - Street 1:948 EMBARCADERO DEL NORTE STE 102
Practice Address - Street 2:
Practice Address - City:ISLA VISTA
Practice Address - State:CA
Practice Address - Zip Code:93117-5106
Practice Address - Country:US
Practice Address - Phone:805-699-6668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-28
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT114978106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist