Individual
KSENIYA SHVACHKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
837 5TH ST FL 2, SANTA ROSA, CA 95404-4526
(707) 522-1800
Mailing address
837 5TH ST FL 2, SANTA ROSA, CA 95404-4526
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A118172
CA
207R00000X
Internal Medicine Physician
A118172
CA
Other
Enumeration date
11/01/2011
Last updated
07/03/2015
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