Provider Demographics
NPI:1427742998
Name:SHUMATE, STEVEN
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:SHUMATE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19107 ANDMARK AVE
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746-2812
Mailing Address - Country:US
Mailing Address - Phone:310-525-7634
Mailing Address - Fax:
Practice Address - Street 1:19107 ANDMARK AVE
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90746-2812
Practice Address - Country:US
Practice Address - Phone:310-525-7634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician