Healthcare Provider Details

I. General information

NPI: 1164805586
Provider Name (Legal Business Name): SHIRLEY MCWILLIAMS ACUPUNCTURE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2015
Last Update Date: 07/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1930 HOWARD RD STE 109
MADERA CA
93637-5155
US

IV. Provider business mailing address

1930 HOWARD RD STE 109
MADERA CA
93637-5155
US

V. Phone/Fax

Practice location:
  • Phone: 559-213-5185
  • Fax: 559-474-8921
Mailing address:
  • Phone: 559-213-5185
  • Fax: 559-474-8921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC7530
License Number StateCA

VIII. Authorized Official

Name: SHIRLEY MCWILLIAMS
Title or Position: PRESIDENT
Credential: LAC
Phone: 559-213-5185