Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 47116 | CA |
Y | 1223D0001X | Dental Public Health | 47116 | CA |
NPI | 1588985121 |
---|---|
Provider Name | Dr. Sheila Lorraine Leffall |
First Address | Vallejo, CA 94591-7860 |
Second Address | Redwood City, CA 94063-1758 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2010 |
Last Update Date | 17/06/2010 |