Provider Demographics
NPI:1083302236
Name:VEALS, LASHONIE
Entity Type:Individual
Prefix:
First Name:LASHONIE
Middle Name:
Last Name:VEALS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6660 LONE TREE WAY STE 4
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-5310
Mailing Address - Country:US
Mailing Address - Phone:510-316-7751
Mailing Address - Fax:
Practice Address - Street 1:2310 MCGINLEY AVE
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-3819
Practice Address - Country:US
Practice Address - Phone:510-575-9277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program