Provider Demographics
NPI:1184937377
Name:SHIU, JOYCELYNN S (PA-C)
Entity type:Individual
Prefix:MRS
First Name:JOYCELYNN
Middle Name:S
Last Name:SHIU
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:JOYCELYNN
Other - Middle Name:P
Other - Last Name:SALONGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:5700 WATT AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH HIGHLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:95660-4752
Mailing Address - Country:US
Mailing Address - Phone:916-338-8360
Mailing Address - Fax:
Practice Address - Street 1:5700 WATT AVE
Practice Address - Street 2:
Practice Address - City:NORTH HIGHLANDS
Practice Address - State:CA
Practice Address - Zip Code:95660-4752
Practice Address - Country:US
Practice Address - Phone:916-338-8360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-16
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA21010363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical