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Individual

MS. GERALDINE MARY SHUTE

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
L.AC

Contact information

Practice address
1240 POWELL ST, SUITE 2A, EMERYVILLE, CA 94608-2600
(510) 672-2210
Mailing address
3518 NEVIN AVE, RICHMOND, CA 94805-2150
(510) 215-7957

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
10541
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CA0105410
BLUE SHIELD CA PROVIDER #
CA
Enumeration date
05/28/2006
Last updated
07/08/2007
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