Provider Demographics
NPI:1427674464
Name:GOLDEN-MCCANTS, SHAVONTAE DANIE (MA)
Entity type:Individual
Prefix:
First Name:SHAVONTAE
Middle Name:DANIE
Last Name:GOLDEN-MCCANTS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9791 GARY DR
Mailing Address - Street 2:
Mailing Address - City:BROWNS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95918-9640
Mailing Address - Country:US
Mailing Address - Phone:916-607-3970
Mailing Address - Fax:
Practice Address - Street 1:SUTTER-YUBA BEHAVIORAL HEALTH
Practice Address - Street 2:1965 LIVE OAK BLVD
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-3794
Practice Address - Country:US
Practice Address - Phone:530-822-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-24
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA134218106H00000X
CA115676101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist