MEDICARE: GIGI NACIONAL SHAFER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1457003634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GIGI NACIONAL SHAFER

Provider Business Mailing Address
First Line	:	2009 LAS ESTRELLAS COURT
Second Line	:
City	:	CAMARILLO
State	:	CA
Zip	:	93012
Country	:	US
Telephone Number	:	805-407-4533
Fax Number	:	805-384-2724

Provider Business Practice Location Address
First Line	:	2009 LAS ESTRELLAS COURT
Second Line	:
City	:	CAMARILLO
State	:	CA
Zip	:	93012
Country	:	US
Telephone Number	:	805-407-4533
Fax Number	:	805-384-2724

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2022
Last Update Date	:	04/30/2024

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Directions to “ GIGI NACIONAL SHAFER ” Practice Location

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