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Individual

EVA JANE SHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP

Contact information

Practice address
6618 VAN NUYS BLVD, VAN NUYS, CA 91405-4617
(818) 908-9962
(818) 908-9914
Mailing address
15477 VENTURA BLVD, THIRD FLOOR, SHERMAN OAKS, CA 91403-3006
(818) 907-0322
(818) 907-0360

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
311173
CA
363LP0200X
Pediatric Nurse Practitioner
NP 8710
CA

Other

Enumeration date
04/02/2010
Last updated
04/02/2010
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