Healthcare Provider Details

I. General information

NPI: 1306762323
Provider Name (Legal Business Name): SHALIYA FIELDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3011 STANTON ST
BERKELEY CA
94702-2729
US

IV. Provider business mailing address

3011 STANTON ST
BERKELEY CA
94702-2729
US

V. Phone/Fax

Practice location:
  • Phone: 510-667-2234
  • Fax:
Mailing address:
  • Phone: 510-667-2234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: