Provider Demographics
NPI:1881943470
Name:NUNEZ-SHAW, LAUREN ELAINE
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:ELAINE
Last Name:NUNEZ-SHAW
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:LAUREN
Other - Middle Name:ELAINE
Other - Last Name:NUNEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9497 SHADOWROCK WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-5400
Mailing Address - Country:US
Mailing Address - Phone:916-690-8373
Mailing Address - Fax:
Practice Address - Street 1:9497 SHADOWROCK WAY
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-5400
Practice Address - Country:US
Practice Address - Phone:916-690-8373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker