Provider Demographics
NPI:1427273150
Name:SHEPHERDSONS, MARJORIE ELAINES (SOCIALWORKER,LCSW)
Entity type:Individual
Prefix:MS
First Name:MARJORIE
Middle Name:ELAINES
Last Name:SHEPHERDSONS
Suffix:
Gender:F
Credentials:SOCIALWORKER,LCSW
Other - Prefix:MISS
Other - First Name:NARJORIE
Other - Middle Name:ELAINE
Other - Last Name:BREEVAART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:440 CORONA DEL MAR
Mailing Address - Street 2:APT. C
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93103-3654
Mailing Address - Country:US
Mailing Address - Phone:805-965-5539
Mailing Address - Fax:805-965-5539
Practice Address - Street 1:440 CORONA DEL MAR
Practice Address - Street 2:APT. C
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93103-3654
Practice Address - Country:US
Practice Address - Phone:805-965-5539
Practice Address - Fax:805-965-5539
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW10883101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health