Individual
SHAVAHNA LANAY ELLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
758 SHELL AVE APT 1, MARTINEZ, CA 94553-3250
(916) 410-5664
Mailing address
756 SHELL AVE APT 8, MARTINEZ, CA 94553-3249
(209) 681-1211
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
02/02/2021
Last updated
02/02/2021
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