Healthcare Provider Details

I. General information

NPI: 1780787713
Provider Name (Legal Business Name): LAURA ANNE SHEEHAN D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 IRVING STREET
SAN FRANCISCO CA
94122
US

IV. Provider business mailing address

3333 1/2 PARADISE DRIVE
TIBURON CA
94920
US

V. Phone/Fax

Practice location:
  • Phone: 415-681-1031
  • Fax: 415-681-3503
Mailing address:
  • Phone: 415-789-1930
  • Fax: 415-681-1031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number28535
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: