Healthcare Provider Details

I. General information

NPI: 1730818170
Provider Name (Legal Business Name): CLAIRE ALEXANDRA SHEPHERD MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2022
Last Update Date: 06/09/2022
Certification Date: 06/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9756 MIKETO WAY
ELK GROVE CA
95757-6247
US

IV. Provider business mailing address

270035 RANGE RD 43
ROCKY VIEW COUNTY ALBERTA
T4C3A2
CA

V. Phone/Fax

Practice location:
  • Phone: 415-967-3375
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License NumberGT61238043
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: