Provider Demographics
NPI:1114463452
Name:ROMERO, SHANENE (LMFT)
Entity type:Individual
Prefix:
First Name:SHANENE
Middle Name:
Last Name:ROMERO
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 1:2538 S POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-5742
Mailing Address - Country:US
Mailing Address - Phone:909-495-5991
Mailing Address - Fax:
Practice Address - Street 1:2538 S POPLAR ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-5742
Practice Address - Country:US
Practice Address - Phone:909-495-5991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-10
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA147041106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist