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General NPI Number Information
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NPI Number | 1316627425
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Entity Type | Individual
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Provider Name | SVETLANA SHEPOVALOVA PHARMD
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Gender | Female
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Dates
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Enumeration Date | 07/24/2023
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Last Update Date | 08/05/2023
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Provider Practice Location Address
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Address Line | 3848 CASTRO VALLEY BLVD
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City | CASTRO VALLEY
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State | CA
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Zip | 94546-4599
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Country | US
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Telephone | 510-886-3341
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Fax |
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Provider Business Mailing Address
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Address Line | 460 N CIVIC DR APT 104
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City | WALNUT CREEK
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State | CA
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Zip | 94596-3345
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Country | US
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Telephone | 925-278-8868
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH88044
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License Number State | CA
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