Healthcare Provider Details

I. General information

NPI: 1740105063
Provider Name (Legal Business Name): JENNY SHUTTERA-CRAIG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 W 6TH ST
MERCED CA
95341-6516
US

IV. Provider business mailing address

1437 PARTRIDGE DR
MERCED CA
95340-8449
US

V. Phone/Fax

Practice location:
  • Phone: 209-385-6676
  • Fax:
Mailing address:
  • Phone: 209-648-1774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP18874
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: