Graciano, Shawn Louise

Graciano, Shawn Louise is an sole proprietor health care provider with primary practice located at 1420 S Central Ave , Glendale CA 91204-2508. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Graciano, Shawn Louise can be contacted via phone (818) 502-2344.

Contact Information

Primary practice address
1420 S Central Ave Glendale CA 91204-2508
Phone: (818) 502-2344
Fax: (818) 502-4501
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA15515 California

Profile Details

NPI number 1144256983
LBN Legal business name Graciano, Shawn Louise
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 23rd, 2006
Last updated Feb 17th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144256983 NPPES
California MEDICAID PA15515

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