Fareshta Shafaq
Student in an Organized Health Care Education/Training Program in French Camp, CA. Individual provider (NPI-1).
NPI number1609623461
StatusActive
Last updated in NPPESMay 15, 2024
Details
- NPI
- 1609623461
- Entity type
- Individual (NPI-1)
- Name
- Fareshta Shafaq
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 1, 2024
- Certification date
- May 15, 2024
- Last updated
- May 15, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
500 W Hospital RdFrench Camp, CA 95231-9693
Phone 209-468-6624
Mailing address
548 Micheletos WayManteca, CA 95336-8539
Phone 209-607-3256
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