Healthcare Provider Details

I. General information

NPI: 1770455362
Provider Name (Legal Business Name): SHAYA LENAE NORMAN MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2025
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3451 W SHAW AVE STE 101
FRESNO CA
93711-3242
US

IV. Provider business mailing address

3451 W SHAW AVE STE 101
FRESNO CA
93711-3242
US

V. Phone/Fax

Practice location:
  • Phone: 559-202-3423
  • Fax:
Mailing address:
  • Phone: 559-202-3423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number140746
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: