Provider Demographics
NPI:1629215595
Name:GOODE, SHAJUANA LAPRIA
Entity Type:Individual
Prefix:MS
First Name:SHAJUANA
Middle Name:LAPRIA
Last Name:GOODE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1060 HOWARD ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2820
Mailing Address - Country:US
Mailing Address - Phone:415-203-9963
Mailing Address - Fax:
Practice Address - Street 1:1060 HOWARD ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2820
Practice Address - Country:US
Practice Address - Phone:415-203-9963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-14
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker