Healthcare Provider Details

I. General information

NPI: 1316425176
Provider Name (Legal Business Name): SHANEE M EUREN RN, BSN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2018
Last Update Date: 06/24/2022
Certification Date: 06/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 SUNRISE AVE STE 145
ROSEVILLE CA
95661-4599
US

IV. Provider business mailing address

2351 SUNSET BLVD, STE 170 #146
ROCKLIN CA
95765
US

V. Phone/Fax

Practice location:
  • Phone: 916-367-1535
  • Fax:
Mailing address:
  • Phone: 916-367-1535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberRN719045
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: