MEDICARE: MICHAL ROKACH-SHAMAY

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	225600000X	Dance Therapist	R-DMT-1937	MD
2	101YM0800X	Mental Health Counselor	IMF74644	CA

General Provider Information

NPI Number	:	1922416049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAL ROKACH-SHAMAY

Provider Business Mailing Address
First Line	:	1051 SANTA FE AVE
Second Line	:
City	:	ALBANY
State	:	CA
Zip	:	94706-2341
Country	:	US
Telephone Number	:	510-333-5058
Fax Number	:

Provider Business Practice Location Address
First Line	:	1051 SANTA FE AVE
Second Line	:
City	:	ALBANY
State	:	CA
Zip	:	94706-2341
Country	:	US
Telephone Number	:	510-333-5058
Fax Number	:

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

Provider Enumeration Date	:	08/01/2014
Last Update Date	:	09/17/2015

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Directions to “ MICHAL ROKACH-SHAMAY ” Practice Location

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