Individual
JOHN COY SHAFFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN,BC
Contact information
Practice address
800 SCENIC DR, MODESTO, CA 95350-6131
(209) 525-5393
(209) 558-4316
Mailing address
1749 JOEL WAY, CERES, CA 95307-4305
(209) 525-5393
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
332522
CA
Other
Enumeration date
03/06/2007
Last updated
11/22/2016
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