Provider Demographics
NPI:1568789071
Name:SHAY, KRISTIN N (DC)
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:N
Last Name:SHAY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7562 ELLIS AVE
Mailing Address - Street 2:APT E2
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-1666
Mailing Address - Country:US
Mailing Address - Phone:717-507-1585
Mailing Address - Fax:
Practice Address - Street 1:6423 E PACIFIC COAST HWY
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90803-4201
Practice Address - Country:US
Practice Address - Phone:562-795-6680
Practice Address - Fax:562-799-9575
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-23
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31519111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor