Provider Demographics
NPI:1669505830
Name:SHOJI, JANE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JANE
Middle Name:
Last Name:SHOJI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1575 N VAN NESS AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93728-1940
Mailing Address - Country:US
Mailing Address - Phone:559-266-2694
Mailing Address - Fax:559-226-0811
Practice Address - Street 1:1575 N VAN NESS AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93728-1940
Practice Address - Country:US
Practice Address - Phone:559-266-2694
Practice Address - Fax:559-226-0811
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA153951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ38089ZMedicare ID - Type Unspecified