Most Relevant Information
Provider Data
| NPI Number: | 1003578196 |
| Provider Name: | SHANI DHARMASENA LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | LCSW102140 |
Most Important Dates
| Enumeration Date: | 10/06/2021 |
| Last Updated: | 10/06/2021 |
Provider Practice Location
1545 SAINT MARKS PLZ
STOCKTON
CA
952076411
Practice Location Phone/Fax
| Phone: | 2097417888 |
| Fax: |
Provider Mailing Location
10946 PEONY PLACE DR
STOCKTON
CA
952093783
Provider Mailing Phone/Fax
| Phone: | 2097417888 |
| Fax: |