Provider Demographics
NPI:1790859478
Name:SHOEMAKER, HELEN JOYCE (MFT)
Entity Type:Individual
Prefix:DR
First Name:HELEN
Middle Name:JOYCE
Last Name:SHOEMAKER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 GARIN AVE
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94544-6815
Mailing Address - Country:US
Mailing Address - Phone:510-471-4379
Mailing Address - Fax:510-487-4487
Practice Address - Street 1:22248 MAIN ST
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-4005
Practice Address - Country:US
Practice Address - Phone:510-471-4379
Practice Address - Fax:510-487-4487
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT #33432101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA243675OtherMENTAL HEALTH NETWORK