Individual
MS. LAURA JANE SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2900 COLOMA ST, PLACERVILLE, CA 95667-4408
(530) 306-7412
Mailing address
2900 COLOMA ST, PLACERVILLE, CA 95667-4408
(530) 306-7412
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
RI-S0903301558
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RI-S0903301558
RAS
CA
Enumeration date
04/05/2010
Last updated
04/05/2010
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