Individual
SHATOYA F JACOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1501 SAN PEDRO DR SE # 128, ALBUQUERQUE, NM 87108-5153
(505) 800-1874
(505) 800-1874
Mailing address
1501 SAN PEDRO DR SE # 128, ALBUQUERQUE, NM 87108-5153
(505) 800-1874
(505) 800-1874
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
100756391
NM
Other
Enumeration date
04/08/2026
Last updated
04/08/2026
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