Individual
MS. SHANNON ANN STALOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LM, CPM
Contact information
Practice address
2479 LE CONTE AVE APT 3, BERKELEY, CA 94709-1236
(408) 464-1441
(510) 991-1562
Mailing address
2479 LE CONTE AVE APT 3, BERKELEY, CA 94709-1236
(408) 464-1441
(510) 991-1562
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
LM249
CA
Other
Enumeration date
12/02/2009
Last updated
08/15/2023
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