Provider Demographics
NPI:1730289455
Name:SHEPPARD, PATRICIA ARCINIEGAS (DC)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ARCINIEGAS
Last Name:SHEPPARD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 DOMINICAN DR
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-1365
Mailing Address - Country:US
Mailing Address - Phone:415-457-6138
Mailing Address - Fax:
Practice Address - Street 1:15 PRINCESS ST
Practice Address - Street 2:SUIT C
Practice Address - City:SAUSALITO
Practice Address - State:CA
Practice Address - Zip Code:94965-2209
Practice Address - Country:US
Practice Address - Phone:415-332-0621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 24606111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition