Individual
DR. VINCENT SHANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYM, PSYD, PHD
Contact information
Practice address
44415 KINGSTON DR, TEMECULA, CA 92592-5621
(951) 265-0809
(951) 302-2038
Mailing address
44415 KINGSTON DR, TEMECULA, CA 92592-5621
(951) 265-0809
(951) 302-2038
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP1600X
Pastoral Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
04/15/2014
Last updated
11/30/2016
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