| Doctor Name: | JEANETTE LOUISE SHATTUCK |
| NPI Number: | 1003948928 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | OTR L |
| License Number: | AA358119 |
| Business Practice Address: | 4772 Katella Ave Ste 100 Los Alamitos, CA - 907202681 |
| Business Phone Number: | 5624308700 |
| Business Fax Number: | 5624308760 |
| Mailing Address: | 4772 Katella Ave Ste 100, LOS ALAMITOS |
| State: | CA |
| Postal Code: | 907202681 |
| Phone Number: | 5624308700 |
| Fax Number: | 5624308760 |
| NPI Enumeration Date: | 03/09/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225000000X |
| License Number: | AA358119 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | CA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Orthotic Fitter |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual trained in the management of fitting prefabricated orthoses. |