Healthcare Provider Details

I. General information

NPI: 1750524237
Provider Name (Legal Business Name): VALERIE CHRISTINE SHEPPARD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2009
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1640 NEWPORT BLVD STE 210
COSTA MESA CA
92627-3786
US

IV. Provider business mailing address

1401 AVOCADO AVE STE 802
NEWPORT BEACH CA
92660-7784
US

V. Phone/Fax

Practice location:
  • Phone: 949-642-7332
  • Fax: 949-642-7335
Mailing address:
  • Phone: 949-644-0970
  • Fax: 949-644-0774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number20A19556
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: