Healthcare Provider Details

I. General information

NPI: 1992243356
Provider Name (Legal Business Name): JOANNE SHINOZAKI D.V.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2017
Last Update Date: 01/08/2021
Certification Date: 01/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2967 N MOORPARK RD
THOUSAND OAKS CA
91360-4573
US

IV. Provider business mailing address

2967 N MOORPARK RD
THOUSAND OAKS CA
91360-4573
US

V. Phone/Fax

Practice location:
  • Phone: 805-492-2436
  • Fax: 805-492-3228
Mailing address:
  • Phone: 805-492-2436
  • Fax: 805-492-3228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberVET12654
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: