MEDICARE: MRS. CLARA SHAYEVICH N.P

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	363L00000X	Nurse Practitioner	NP6331	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578620050
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CLARA SHAYEVICH N.P

Provider Business Mailing Address
First Line	:	145 GUERRERO ST
Second Line	:	SUITE #415
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94103-1066
Country	:	US
Telephone Number	:	415-771-4072
Fax Number	:	650-992-1426

Provider Business Practice Location Address
First Line	:	2320 SUTTER ST
Second Line	:	SUITE #101
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94115-3038
Country	:	US
Telephone Number	:	415-771-4072
Fax Number	:	650-992-1426

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

Provider Enumeration Date	:	01/03/2007
Last Update Date	:	07/08/2007

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