Provider Demographics
NPI:1659560639
Name:SHOJI, KENN SCOTT (DC)
Entity Type:Individual
Prefix:DR
First Name:KENN
Middle Name:SCOTT
Last Name:SHOJI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1911 RICHMOND ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-0431
Mailing Address - Country:US
Mailing Address - Phone:916-487-7156
Mailing Address - Fax:
Practice Address - Street 1:1911 RICHMOND ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-0431
Practice Address - Country:US
Practice Address - Phone:916-487-7156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-16
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC23111111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner