Provider Demographics
NPI:1780787713
Name:SHEEHAN, LAURA ANNE (DC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ANNE
Last Name:SHEEHAN
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 1:3333 1/2 PARADISE DRIVE
Mailing Address - Street 2:
Mailing Address - City:TIBURON
Mailing Address - State:CA
Mailing Address - Zip Code:94920
Mailing Address - Country:US
Mailing Address - Phone:415-789-1930
Mailing Address - Fax:415-681-1031
Practice Address - Street 1:915 IRVING STREET
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122
Practice Address - Country:US
Practice Address - Phone:415-681-1031
Practice Address - Fax:415-681-3503
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28535111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic