Provider Demographics
NPI:1861768525
Name:EDWARDS, SHAUNNA JEANNE (LCSW)
Entity type:Individual
Prefix:
First Name:SHAUNNA
Middle Name:JEANNE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SHAUNNA
Other - Middle Name:JEANNE
Other - Last Name:MURTHA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:395 TAYLOR BLVD STE 115
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-2298
Mailing Address - Country:US
Mailing Address - Phone:925-917-1112
Mailing Address - Fax:925-848-2116
Practice Address - Street 1:395 TAYLOR BLVD STE 115
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-2298
Practice Address - Country:US
Practice Address - Phone:925-917-1112
Practice Address - Fax:925-848-2116
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-28
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS281051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical