Provider Demographics
NPI:1205319399
Name:SAENZ, SHIRLEY MILUZKA (CHW SUPERVISOR)
Entity type:Individual
Prefix:MISS
First Name:SHIRLEY
Middle Name:MILUZKA
Last Name:SAENZ
Suffix:
Gender:F
Credentials:CHW SUPERVISOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 UNIVERSITY AVE SOM EDUCATION BUILDING I
Mailing Address - Street 2:OFFICE 2669
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92521-1520
Mailing Address - Country:US
Mailing Address - Phone:951-827-3412
Mailing Address - Fax:
Practice Address - Street 1:900 UNIVERSITY AVE SOM EDUCATION BUILDING I
Practice Address - Street 2:OFFICE 2669
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92521-1520
Practice Address - Country:US
Practice Address - Phone:951-827-3412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-13
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No174H00000XOther Service ProvidersHealth Educator