Healthcare Provider Details

I. General information

NPI: 1083057574
Provider Name (Legal Business Name): AKI SHISHIDO CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2013
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1353 OLD TEMESCAL RD STE 103
CORONA CA
92881-7257
US

IV. Provider business mailing address

341 MAGNOLIA AVE STE 201
CORONA CA
92879-3332
US

V. Phone/Fax

Practice location:
  • Phone: 951-547-4208
  • Fax: 866-777-8014
Mailing address:
  • Phone: 951-547-4208
  • Fax: 866-777-8014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberF0015401
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number235683
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: