Healthcare Provider Details

I. General information

NPI: 1891003158
Provider Name (Legal Business Name): SHEILA BRICE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2010
Last Update Date: 09/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1008 W AVENUE J10
LANCASTER CA
93534-4828
US

IV. Provider business mailing address

4756 W AVENUE J2
LANCASTER CA
93536-2307
US

V. Phone/Fax

Practice location:
  • Phone: 661-943-7393
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: