Provider Demographics
NPI:1255470324
Name:HIJAZI, SHAULA (NP)
Entity Type:Individual
Prefix:MS
First Name:SHAULA
Middle Name:
Last Name:HIJAZI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 459
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93116-0459
Mailing Address - Country:US
Mailing Address - Phone:805-563-5003
Mailing Address - Fax:805-563-3212
Practice Address - Street 1:1805 E CABRILLO BLVD
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93108-2884
Practice Address - Country:US
Practice Address - Phone:805-563-5003
Practice Address - Fax:805-563-3212
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2017-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANPF2235 & RN288274363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q21403Medicare UPIN
CANP2235Medicare ID - Type Unspecified