Provider Demographics
NPI:1780712182
Name:SHIFFER, JUDY
Entity type:Individual
Prefix:MS
First Name:JUDY
Middle Name:
Last Name:SHIFFER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:694 SANDY AVE
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-1452
Mailing Address - Country:US
Mailing Address - Phone:760-370-0341
Mailing Address - Fax:
Practice Address - Street 1:694 SANDY AVE
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-1452
Practice Address - Country:US
Practice Address - Phone:760-370-0341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor