Healthcare Provider Details

I. General information

NPI: 1639083496
Provider Name (Legal Business Name): SHANAI CHUNG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

479 CRESCENT ST APT 30
OAKLAND CA
94610-2608
US

IV. Provider business mailing address

119 TUSCANY CT
HERCULES CA
94547-2204
US

V. Phone/Fax

Practice location:
  • Phone: 415-960-7180
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: