Provider Demographics
NPI:1790099224
Name:NAVARRO, SHIRLEY HO (NP)
Entity Type:Individual
Prefix:MRS
First Name:SHIRLEY
Middle Name:HO
Last Name:NAVARRO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:SHIRLEY
Other - Middle Name:
Other - Last Name:HO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:18111 NORDHOFF ST
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91330-0001
Mailing Address - Country:US
Mailing Address - Phone:818-677-3118
Mailing Address - Fax:818-677-2304
Practice Address - Street 1:18111 NORDHOFF STREET
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:93110
Practice Address - Country:US
Practice Address - Phone:818-677-3118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-26
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19964363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner