Individual
ANNETTE AMBITO SHEPHERD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
340 4TH AVE STE 11, CHULA VISTA, CA 91910
(619) 422-6158
Mailing address
340 4TH AVE STE 11, CHULA VISTA, CA 91910-3813
(619) 422-6158
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
95008959
CA
363LP2300X
Primary Care Nurse Practitioner
Primary
95008959
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95008959
CALIFORNIA BOARD OF NURSING NURSE PRACTITIONER CERTIFICATE
CA
Enumeration date
06/16/2018
Last updated
06/21/2018
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