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Shane Michael Short
Addiction (Substance Use Disorder) Counselor in Santa Rosa, California
NPI 1528625738

Shane Michael Short is an Addiction (Substance Use Disorder) Counselor based in Santa Rosa, CA and is specialized in Addiction (Substance Use Disorder). Shane Michael Short practices in Santa Rosa, CA. The NPI Number for Shane Michael Short is 1528625738 and holds a License No. (California).

The current practice location address for Shane Michael Short is 2403 Professional Dr, Santa Rosa, CA and can be reached out via phone at 707-544-3295.

Location: 2403 Professional Dr, Santa Rosa, CA, 95403-3007
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1528625738
Provider Name
Shane Michael Short
Credential
Provider Entity Type
Individual
Gender
Male
Address
2403 Professional Dr, Santa Rosa, CA, 95403-3007
Phone Number
707-544-3295
Fax Number
Provider Enumeration Date
05/22/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
101YA0400X 05 CA
institution
Provider Business Practice Location Address Details
Address
2403 Professional Dr
City
Santa Rosa
State
California
Zip
95403-3007
Phone Number
707-544-3295
Fax Number
person
Provider Business Mailing Address Details
Address
2403 Professional Dr
City
Santa Rosa
State
California
Zip
95403-3007
Phone Number
707-544-3295
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
()
Definition
Definition to come...
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