Individual
MS. COLLEEN ANN SHIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 WILSHIRE BLVD, SUITE 500, LOS ANGELES, CA 90057-4303
(213) 639-0204
Mailing address
3339 MENTONE AVE, #8, LOS ANGELES, CA 90034-4621
(310) 837-4369
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
31383
CA
Other
Enumeration date
08/10/2009
Last updated
08/10/2009
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