Healthcare Provider Details

I. General information

NPI: 1245528462
Provider Name (Legal Business Name): DAVID SHOEMAKER LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2011
Last Update Date: 05/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1680 DAVID E COOK WAY
CLOVIS CA
93611-2505
US

IV. Provider business mailing address

1680 DAVID E COOK WAY
CLOVIS CA
93611-2505
US

V. Phone/Fax

Practice location:
  • Phone: 559-327-9441
  • Fax: 559-327-9440
Mailing address:
  • Phone: 559-327-9441
  • Fax: 559-327-9440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC 44165
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: