Provider Demographics
NPI:1891939054
Name:SMOLINSKI, SHAWN MICHAEL (LAC, DIPL OM)
Entity Type:Individual
Prefix:MR
First Name:SHAWN
Middle Name:MICHAEL
Last Name:SMOLINSKI
Suffix:
Gender:M
Credentials:LAC, DIPL OM
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:740 FRONT ST
Mailing Address - Street 2:STE 318
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-4535
Mailing Address - Country:US
Mailing Address - Phone:831-334-5971
Mailing Address - Fax:831-471-8064
Practice Address - Street 1:740 FRONT ST
Practice Address - Street 2:STE 318
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-4535
Practice Address - Country:US
Practice Address - Phone:831-334-5971
Practice Address - Fax:831-471-8064
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-30
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA12547171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist