Individual
SHANNON RAE SGRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
1412 BLUE OAKS BLVD, ROSEVILLE, CA 95747-7143
(916) 784-7546
(916) 784-7548
Mailing address
1412 BLUE OAKS BLVD, ROSEVILLE, CA 95747-7143
(916) 784-7546
(916) 784-7548
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA15649
CA
Other
Enumeration date
05/24/2006
Last updated
08/01/2016
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