Individual provider · Type 1 NPI

Johnathan Shaw

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

NPI number 1558725952 Active

Practice location

9961 Sierra Ave
Fontana, CA 92335-6720

Call (909) 427-2608 Map

Fax (909) 427-5312

Mailing address

17234 Valley Blvd
Fontana, CA 92335

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 1558725952

Johnathan Shaw's National Provider Identifier is 1558725952, issued on Apr 12, 2016. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Fontana, CA. The record was last updated on Dec 8, 2021.