Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | DC28022 | CA |
N | 111NI0900X | Internist | DC28022 | CA |
N | 111NS0005X | Chiropractic Sports Physician | DC28022 | CA |
Y | 111NX0800X | Chiropractor Orthopedic Specialist | DC28022 | CA |
NPI | 1073651600 |
---|---|
Provider Name | Dr. Stacy Ann Shulenberger |
First Address | Danville, CA 94526-3452 |
Second Address | Danville, CA 94526-3452 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2007 |
Last Update Date | 30/10/2013 |