Individual provider · Type 1 NPI

Lisa Marie Shaw

Student in an Organized Health Care Education/Training Program · Berkeley, CA

NPI number 1104659168 Active

Practice location

2130 Center St Ste 200
Berkeley, CA 94704-1386

Call (510) 548-8283 Map

Fax (510) 548-2938

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1104659168

Lisa Marie Shaw's National Provider Identifier is 1104659168, issued on Aug 23, 2024. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Berkeley, CA. The record was last updated on Aug 23, 2024.