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Organization
SHINE MEDICAL OF CA PC
Active
Organization
SHINE MEDICAL OF CA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLARE FRANCES BOALS FRYE (SVP OF OPERATIONS)
(616) 648-1196
Entity
Organization
Contact information
Practice address
325 S 1ST ST STE 200, SAN JOSE, CA 95113-2835
(888) 380-2028
Mailing address
PO BOX 52475, PHOENIX, AZ 85072-2475
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
07/19/2022
Last updated
09/15/2026
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