Provider Demographics
NPI:1811078116
Name:SHOQUIST, MARSHALL LEIGH (PH D)
Entity type:Individual
Prefix:DR
First Name:MARSHALL
Middle Name:LEIGH
Last Name:SHOQUIST
Suffix:
Gender:M
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 SOQUEL AVE STE A
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-2348
Mailing Address - Country:US
Mailing Address - Phone:831-426-6610
Mailing Address - Fax:831-401-2337
Practice Address - Street 1:305 SOQUEL AVE STE A
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-2348
Practice Address - Country:US
Practice Address - Phone:831-426-6610
Practice Address - Fax:831-401-2337
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU 461231H00000X
CAHA 1054237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Not Answered237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter