(800) 868-1923

Most Relevant Information


Provider Data
NPI Number: 1003527417
Provider Name: SHELLEY RAE VAN GUNDY OCONNOR
Entity Type: Individual
Taxonomy Code: 247200000X
Specialty: Technician, Other
License Number:
Most Important Dates
Enumeration Date: 12/06/2022
Last Updated: 12/06/2022
Provider Practice Location
2227 CAPRICORN WAY STE 201
SANTA ROSA
CA
954075478
Practice Location Phone/Fax
Phone: 7075654854
Fax:
Provider Mailing Location
2227 CAPRICORN WAY STE 201
SANTA ROSA
CA
954075478
Provider Mailing Phone/Fax
Phone: 7075654854
Fax: