Individual
DR. ELISA SHEPARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
12625 LA MIRADA BLVD STE 202, LA MIRADA, CA 90638-2213
(562) 903-4800
Mailing address
12625 LA MIRADA BLVD STE 202, LA MIRADA, CA 90638-2213
(562) 903-4800
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
26792
CA
Other
Enumeration date
08/24/2015
Last updated
08/24/2015
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