Provider Demographics
NPI:1063612364
Name:ROGERS, SHEILAH ELIZABETH (LAC)
Entity type:Individual
Prefix:MS
First Name:SHEILAH
Middle Name:ELIZABETH
Last Name:ROGERS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:862 FOLSOM ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-1123
Mailing Address - Country:US
Mailing Address - Phone:415-730-4144
Mailing Address - Fax:
Practice Address - Street 1:862 FOLSOM ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94107-1123
Practice Address - Country:US
Practice Address - Phone:415-730-4144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-24
Last Update Date:2016-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC10542171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist