Individual
MRS. TARA A SHEALY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
446 ALTA RD, SUITE 6100, SAN DIEGO, CA 92158-0001
(619) 671-6533
Mailing address
11272 CORTE PLAYA MADERA, SAN DIEGO, CA 92124-4137
(858) 292-4600
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
392596
CA
Other
Enumeration date
03/02/2007
Last updated
07/08/2007
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