Provider Demographics
NPI:1194235051
Name:SHEKLIAN, BRENDA LOUISE (CFM)
Entity type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:LOUISE
Last Name:SHEKLIAN
Suffix:
Gender:F
Credentials:CFM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1132 W MURRAY AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-4718
Mailing Address - Country:US
Mailing Address - Phone:559-627-9447
Mailing Address - Fax:559-627-9447
Practice Address - Street 1:1132 W MURRAY AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-4718
Practice Address - Country:US
Practice Address - Phone:559-627-9447
Practice Address - Fax:559-627-9447
Is Sole Proprietor?:No
Enumeration Date:2017-10-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMastectomy Fitter