Provider Demographics
NPI:1558693770
Name:SHALHOUB, BELINDA ANNE (SRNA)
Entity Type:Individual
Prefix:
First Name:BELINDA
Middle Name:ANNE
Last Name:SHALHOUB
Suffix:
Gender:F
Credentials:SRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13419 CANYON CREST RD
Mailing Address - Street 2:
Mailing Address - City:YUCAIPA
Mailing Address - State:CA
Mailing Address - Zip Code:92399-5823
Mailing Address - Country:US
Mailing Address - Phone:909-534-3184
Mailing Address - Fax:909-795-2222
Practice Address - Street 1:13419 CANYON CREST RD
Practice Address - Street 2:
Practice Address - City:YUCAIPA
Practice Address - State:CA
Practice Address - Zip Code:92399-5823
Practice Address - Country:US
Practice Address - Phone:909-534-3184
Practice Address - Fax:909-795-2222
Is Sole Proprietor?:No
Enumeration Date:2010-02-12
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3957367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered