Provider Demographics
NPI:1942067798
Name:SHEPHERD H LLC
Entity Type:Organization
Organization Name:SHEPHERD H LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LYDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:NJIE
Authorized Official - Suffix:II
Authorized Official - Credentials:NP
Authorized Official - Phone:424-222-3993
Mailing Address - Street 1:910 S CASWELL AVE # CA
Mailing Address - Street 2:
Mailing Address - City:COMPTON
Mailing Address - State:CA
Mailing Address - Zip Code:90220-3918
Mailing Address - Country:US
Mailing Address - Phone:424-222-3993
Mailing Address - Fax:
Practice Address - Street 1:910 S CASWELL AVE
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90220-3918
Practice Address - Country:US
Practice Address - Phone:424-222-3993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-28
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty