Provider Demographics
NPI:1528889664
Name:ACOJEDO, SHAIRAH MYRRH DAJAO
Entity type:Individual
Prefix:DR
First Name:SHAIRAH MYRRH
Middle Name:DAJAO
Last Name:ACOJEDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10456 FOSSIL WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95757-1660
Mailing Address - Country:US
Mailing Address - Phone:530-566-6424
Mailing Address - Fax:
Practice Address - Street 1:1214 N BEALE RD
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:CA
Practice Address - Zip Code:95901-6283
Practice Address - Country:US
Practice Address - Phone:530-491-2717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH87995183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist