Provider Demographics
NPI:1548987571
Name:MCDANIEL-DAVIS, SHAYNA JOY (CNM, WHNP-BC)
Entity type:Individual
Prefix:
First Name:SHAYNA
Middle Name:JOY
Last Name:MCDANIEL-DAVIS
Suffix:
Gender:F
Credentials:CNM, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 ODYSSEY STE 200
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3197
Mailing Address - Country:US
Mailing Address - Phone:949-253-7626
Mailing Address - Fax:
Practice Address - Street 1:22 ODYSSEY STE 200
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3197
Practice Address - Country:US
Practice Address - Phone:949-253-7626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-20
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95022804363LW0102X
CA236308367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health