Healthcare Provider Details

I. General information

NPI: 1275446627
Provider Name (Legal Business Name): CADY LAUREN SHAMULUS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27555 YNEZ RD STE 300
TEMECULA CA
92591-4678
US

IV. Provider business mailing address

24540 BIG COUNTRY DR
MENIFEE CA
92584-1302
US

V. Phone/Fax

Practice location:
  • Phone: 951-694-0100
  • Fax:
Mailing address:
  • Phone: 951-834-4522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: