Healthcare Provider Details

I. General information

NPI: 1689031817
Provider Name (Legal Business Name): SHAFFER GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2016
Last Update Date: 09/21/2020
Certification Date: 09/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40315 BELLEVUE DR
TEMECULA CA
92591-7563
US

IV. Provider business mailing address

40335 WINCHESTER RD STE 280
TEMECULA CA
92591-5500
US

V. Phone/Fax

Practice location:
  • Phone: 951-595-2764
  • Fax:
Mailing address:
  • Phone: 951-595-2764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW27326
License Number StateCA

VIII. Authorized Official

Name: STEPHANIE SHAFFER
Title or Position: PRESIDENT
Credential:
Phone: 951-595-2764