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General NPI Number Information
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NPI Number | 1952892366
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Entity Type | Individual
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Provider Name | LISA CINDY SHAW L.AC
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Gender | Female
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Dates
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Enumeration Date | 05/21/2018
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Last Update Date | 05/21/2018
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Provider Practice Location Address
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Address Line | 1850 FAIRWAY DR
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City | SAN LEANDRO
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State | CA
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Zip | 94577-5629
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Country | US
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Telephone | 844-319-1150
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Fax |
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Provider Business Mailing Address
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Address Line | 5768 VICENTE ST
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City | OAKLAND
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State | CA
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Zip | 94609-1714
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Country | US
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Telephone | 510-654-4267
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC17718
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License Number State | CA
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