Provider Demographics
NPI:1932260379
Name:SHAW, HELEN N (DC)
Entity Type:Individual
Prefix:DR
First Name:HELEN
Middle Name:N
Last Name:SHAW
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 SARATOGA AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-2331
Mailing Address - Country:US
Mailing Address - Phone:408-253-3396
Mailing Address - Fax:
Practice Address - Street 1:855 SARATOGA AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129-2331
Practice Address - Country:US
Practice Address - Phone:408-253-3396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2009-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC20787111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA770335473OtherTAX ID #
CADC20787OtherCHIROPRACTIC LICENSE #
CADC20787OtherCHIROPRACTIC LICENSE #