Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 98932 | CA |
N | 104100000X | Social Worker | 64110 | CA |
N | 104100000X | Social Worker | 98932 | CA |
N | 225400000X | Rehabilitation Practitioner |
NPI | 1053738211 |
---|---|
Provider Name | Ayana Shepherd |
First Address | Torrance, CA 90505-2340 |
Second Address | Torrance, CA 90505-2340 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2014 |
Last Update Date | 15/07/2021 |