Provider Demographics
NPI:1497730907
Name:SHAW, HOWARD JAY (FNP)
Entity Type:Individual
Prefix:MR
First Name:HOWARD
Middle Name:JAY
Last Name:SHAW
Suffix:
Gender:M
Credentials:FNP
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Mailing Address - Street 1:694 GLENSIDE DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-5353
Mailing Address - Country:US
Mailing Address - Phone:925-283-1694
Mailing Address - Fax:925-283-2544
Practice Address - Street 1:2500 ALHAMBRA AVE
Practice Address - Street 2:CONTRA COSTA COUNTY HOSPITALS AND CLINICS
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-3156
Practice Address - Country:US
Practice Address - Phone:510-231-1200
Practice Address - Fax:510-231-1201
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-08
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA351655363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMS0491390OtherDEA
CAZZZ00541ZMedicare ID - Type Unspecified
CAMS0491390OtherDEA