Provider Demographics
NPI:1851993315
Name:NORMAN, SHAWNA ARNEASE (CLIENT SERVICE)
Entity Type:Individual
Prefix:MRS
First Name:SHAWNA
Middle Name:ARNEASE
Last Name:NORMAN
Suffix:
Gender:F
Credentials:CLIENT SERVICE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9925 INTERNATIONAL BLVD STE 5
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94603-2558
Mailing Address - Country:US
Mailing Address - Phone:510-777-1177
Mailing Address - Fax:
Practice Address - Street 1:9925 INTERNATIONAL BLVD STE 5
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94603-2558
Practice Address - Country:US
Practice Address - Phone:510-777-1177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker