Provider Demographics
NPI:1376014415
Name:BANBURY, SHERA (MA ED)
Entity Type:Individual
Prefix:MS
First Name:SHERA
Middle Name:
Last Name:BANBURY
Suffix:
Gender:F
Credentials:MA ED
Other - Prefix:MRS
Other - First Name:SHERA
Other - Middle Name:
Other - Last Name:CONNIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:199 HIGHLANDS CT
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-5225
Mailing Address - Country:US
Mailing Address - Phone:530-277-9390
Mailing Address - Fax:
Practice Address - Street 1:13192 BRUNSWICK RD
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-9388
Practice Address - Country:US
Practice Address - Phone:530-273-0631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist