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General NPI Number Information
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NPI Number | 1811401482
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Entity Type | Individual
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Provider Name | LATASHA SHAW LVN
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Gender | Female
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Dates
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Enumeration Date | 11/19/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 1014 CALLOWAY DR
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City | BAKERSFIELD
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State | CA
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Zip | 93312-6337
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Country | US
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Telephone | 661-630-7600
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Fax |
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Provider Business Mailing Address
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Address Line | 8100 SPARTANS DR
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City | BAKERSFIELD
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State | CA
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Zip | 93313-5449
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Country | US
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Telephone | 661-912-7169
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number | 290342
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License Number State | CA
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