Provider Demographics
NPI:1245528462
Name:SHOEMAKER, DAVID (LMFT)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:SHOEMAKER
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1680 DAVID E COOK WAY
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-2505
Mailing Address - Country:US
Mailing Address - Phone:559-327-9441
Mailing Address - Fax:559-327-9440
Practice Address - Street 1:1680 DAVID E COOK WAY
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-2505
Practice Address - Country:US
Practice Address - Phone:559-327-9441
Practice Address - Fax:559-327-9440
Is Sole Proprietor?:No
Enumeration Date:2011-07-21
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 44165106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist