Provider Demographics
NPI:1396807392
Name:CERASARO, SHELLEY (ND)
Entity type:Individual
Prefix:DR
First Name:SHELLEY
Middle Name:
Last Name:CERASARO
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 LOCUST ST STE 204
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-2836
Mailing Address - Country:US
Mailing Address - Phone:530-242-8888
Mailing Address - Fax:530-242-8889
Practice Address - Street 1:221 LOCUST ST STE 204
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-2836
Practice Address - Country:US
Practice Address - Phone:530-242-8888
Practice Address - Fax:530-242-8889
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND-247175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath