MEDICARE: SHAMECA WOMACK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	AII063480423	CA

General Provider Information

NPI Number	:	1215262522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAMECA WOMACK

Provider Business Mailing Address
First Line	:	1492 CERRITOS AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90813-2126
Country	:	US
Telephone Number	:	562-225-0371
Fax Number	:

Provider Business Practice Location Address
First Line	:	505 S PACIFIC AVE
Second Line	:
City	:	SAN PEDRO
State	:	CA
Zip	:	90731-2656
Country	:	US
Telephone Number	:	310-519-8723
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2009
Last Update Date	:	04/10/2025

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Directions to “ SHAMECA WOMACK ” Practice Location

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