Provider Demographics
NPI:1033958897
Name:SHAW, CHERINA (E-RYT 500)
Entity type:Individual
Prefix:
First Name:CHERINA
Middle Name:
Last Name:SHAW
Suffix:
Gender:F
Credentials:E-RYT 500
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2326 DARIO CIR
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95209-2325
Mailing Address - Country:US
Mailing Address - Phone:916-996-9407
Mailing Address - Fax:
Practice Address - Street 1:2326 DARIO CIR
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95209-2325
Practice Address - Country:US
Practice Address - Phone:916-996-9407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No171400000XOther Service ProvidersHealth & Wellness Coach
No174N00000XOther Service ProvidersLactation Consultant, Non-RN
No175T00000XOther Service ProvidersPeer Specialist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No253Z00000XAgenciesIn Home Supportive Care