Individual
MISS NICOLE JUN SHIMOTAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1470 SUNSET LOOP, LAFAYETTE, CA 94549-6045
(925) 817-7404
Mailing address
1470 SUNSET LOOP, LAFAYETTE, CA 94549-6045
(925) 817-7404
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
07/10/2017
Last updated
07/21/2022
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