Healthcare Provider Details

I. General information

NPI: 1710326699
Provider Name (Legal Business Name): SHEILA ELIZABETH VAUGHAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2013
Last Update Date: 06/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5674 STONERIDGE DR SUITE 207
PLEASANTON CA
94588-8500
US

IV. Provider business mailing address

5674 STONERIDGE DR SUITE 207
PLEASANTON CA
94588-8500
US

V. Phone/Fax

Practice location:
  • Phone: 925-520-0005
  • Fax: 925-520-0005
Mailing address:
  • Phone: 925-520-0005
  • Fax: 925-520-0005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number822118
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: