Individual
BENITA SHEPHERD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
468 VALLE VISTA AVE, VALLEJO, CA 94590-3441
(415) 812-0520
Mailing address
468 VALLE VISTA AVE, VALLEJO, CA 94590-3441
(415) 812-0520
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
NA0060036487
TX
Other
Enumeration date
04/27/2023
Last updated
04/27/2023
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