Macedo, Shandalee Kimberlee

Macedo, Shandalee Kimberlee is an individual health care provider with primary practice located at 1365 Ohio Ave Apt 304 , Long Beach CA 90804-2450. She recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Family, Behavioral Health & Social Service Providers / School, Dental Providers / Dentist. Dental Providers / Dentist is her primary health care specialty. Macedo, Shandalee Kimberlee can be contacted via phone (951) 807-8204.

Contact Information

Primary practice address
1365 Ohio Ave Apt 304 Long Beach CA 90804-2450
Phone: (951) 807-8204
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Behavioral Health & Social Service Providers / Family 103TF0000X
Behavioral Health & Social Service Providers / School 103TS0200X
Dental Providers / Dentist 122300000X 29049 New York

Profile Details

NPI number 1659142040
LBN Legal business name Macedo, Shandalee Kimberlee
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 15th, 2024
Last updated Jan 15th, 2024 - about 10 months 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 1659142040 NPPES
District of Columbia MEDICAID 236
District of Columbia Other 5874
District of Columbia Other 568946544

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