Provider Demographics
NPI:1902968605
Name:SHOEMAKER, SHERRY INTRIERE (SHERRY SHOEMAKER)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:INTRIERE
Last Name:SHOEMAKER
Suffix:
Gender:F
Credentials:SHERRY SHOEMAKER
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:
Other - Last Name:SHOEMAKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC
Mailing Address - Street 1:1042 W EL NORTE PKWY
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92026-3341
Mailing Address - Country:US
Mailing Address - Phone:760-480-7555
Mailing Address - Fax:760-480-7593
Practice Address - Street 1:1042 W EL NORTE PKWY
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92026-3341
Practice Address - Country:US
Practice Address - Phone:760-480-7555
Practice Address - Fax:760-480-7593
Is Sole Proprietor?:No
Enumeration Date:2006-12-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7681171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist