Provider Demographics
NPI:1184712812
Name:CHAVEZ, SHIRLEY (RN, NP)
Entity type:Individual
Prefix:MRS
First Name:SHIRLEY
Middle Name:
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1691 THE ALAMEDA
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-2203
Mailing Address - Country:US
Mailing Address - Phone:408-287-7532
Mailing Address - Fax:408-287-0405
Practice Address - Street 1:1119 PACIFIC AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-7503
Practice Address - Country:US
Practice Address - Phone:831-426-5550
Practice Address - Fax:831-425-0106
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN481177163WW0101X
CANP8647363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory