Provider Demographics
NPI:1518233741
Name:SHOZUYA, NADINE (LAC)
Entity Type:Individual
Prefix:MS
First Name:NADINE
Middle Name:
Last Name:SHOZUYA
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2140 ARTESIA BLVD
Mailing Address - Street 2:STE A
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-3046
Mailing Address - Country:US
Mailing Address - Phone:310-617-3075
Mailing Address - Fax:
Practice Address - Street 1:2140 ARTESIA BLVD
Practice Address - Street 2:STE A
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90504-3046
Practice Address - Country:US
Practice Address - Phone:310-617-3075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-02
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14639171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist