| Doctor Name: | SALLY K SHEPHERD |
| NPI Number: | 1235256041 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | C.L.S. |
| License Number: | MTA17894 |
| Business Practice Address: | 3800 Janes Rd Arcata, CA - 955214742 |
| Business Phone Number: | 7078268265 |
| Business Fax Number: | |
| Mailing Address: | 8928 Diamond Falls Dr, LAS VEGAS |
| State: | NV |
| Postal Code: | 891175700 |
| Phone Number: | 7025956807 |
| Fax Number: | |
| NPI Enumeration Date: | 03/25/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 246QM0706X |
| License Number: | MTA17894 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Spec/Tech, Pathology |
| Taxonomy Specialization: | Medical Technologist |
| Taxonomy Definition: | |