Individual
SHELLEY RAE VAN GUNDY OCONNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2227 CAPRICORN WAY STE 201, SANTA ROSA, CA 95407-5478
(707) 565-4854
Mailing address
2227 CAPRICORN WAY STE 201, SANTA ROSA, CA 95407-5478
(707) 565-4854
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
12/06/2022
Last updated
12/06/2022
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