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Letitia Renee Shackleford-oliver
Other Specialist/Technologist in Vallejo, California
NPI 1730839085

Letitia Renee Shackleford-oliver is a Other Specialist/Technologist based in Vallejo, CA. Letitia Renee Shackleford-oliver practices in Vallejo, CA. The NPI Number for Letitia Renee Shackleford-oliver is 1730839085 and holds a License No. (California).

The current practice location address for Letitia Renee Shackleford-oliver is 1628 Broadway St, Vallejo, CA and can be reached out via phone at 077-649-8300.

Location: 1628 Broadway St, Vallejo, CA, 94590-2405
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1730839085
Provider Name
Letitia Renee Shackleford-oliver
Credential
Provider Entity Type
Individual
Gender
Female
Address
1628 Broadway St, Vallejo, CA, 94590-2405
Phone Number
077-649-8300
Fax Number
Provider Enumeration Date
03/28/2022
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1479 01 CA TOWER ID
institution
Provider Business Practice Location Address Details
Address
1628 Broadway St
City
Vallejo
State
California
Zip
94590-2405
Phone Number
077-649-8300
Fax Number
person
Provider Business Mailing Address Details
Address
1628 Broadway St
City
Vallejo
State
California
Zip
94590-2405
Phone Number
077-649-8300
Fax Number
person
Provider's Taxonomy Details 1
Type
Technologists, Technicians & Other Technical Service Providers
Classification
Specialist/Technologist, Other
Speciality
-
Taxonomy
246Z00000X
License No.
()
Definition
General classification identifying individuals trained on specific equipment and technical procedures in one of a collection of miscellaneous healthcare disciplines.
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