Provider Demographics
NPI:1063721546
Name:SAPERSTEIN, SHAWNA LYNN
Entity type:Individual
Prefix:MS
First Name:SHAWNA
Middle Name:LYNN
Last Name:SAPERSTEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:SHAWNA
Other - Middle Name:SAPERSTEIN
Other - Last Name:GALASSI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 82
Mailing Address - Street 2:
Mailing Address - City:PISMO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:93448-0082
Mailing Address - Country:US
Mailing Address - Phone:805-709-2422
Mailing Address - Fax:
Practice Address - Street 1:118 NEVADA ST
Practice Address - Street 2:
Practice Address - City:ARROYO GRANDE
Practice Address - State:CA
Practice Address - Zip Code:93420-2610
Practice Address - Country:US
Practice Address - Phone:805-709-2422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-30
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT98184106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist