Provider Demographics
NPI:1902017833
Name:SHEPARD, MAUREEN (CCH)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:SHEPARD
Suffix:
Gender:F
Credentials:CCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 19594
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95819-0594
Mailing Address - Country:US
Mailing Address - Phone:916-397-6345
Mailing Address - Fax:
Practice Address - Street 1:3408 I ST
Practice Address - Street 2:#2
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-4572
Practice Address - Country:US
Practice Address - Phone:916-397-6345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath