Provider Demographics
NPI:1689225419
Name:SHEARER, VERNA LYNN
Entity Type:Individual
Prefix:
First Name:VERNA
Middle Name:LYNN
Last Name:SHEARER
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 1:6713 INDIANA AVE # 88
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-4263
Mailing Address - Country:US
Mailing Address - Phone:513-257-9158
Mailing Address - Fax:
Practice Address - Street 1:7945 HORIZON VIEW DR
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-7568
Practice Address - Country:US
Practice Address - Phone:513-257-9158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty