Individual
MS. SHARON SIMARA WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HS
Contact information
Practice address
202 BLOSSOM CT, PASO ROBLES, CA 93446-2870
(808) 780-7038
Mailing address
202 BLOSSOM CT, PASO ROBLES, CA 93446-2870
(808) 780-7038
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
08/28/2007
Last updated
08/28/2007
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