Most Relevant Information
Provider Data
| NPI Number: | 1003563958 |
| Provider Name: | CODY ALLEN SHEPHERD |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/09/2022 |
| Last Updated: | 03/09/2022 |
Provider Practice Location
993 POSTAL WAY
VISTA
CA
920836945
Practice Location Phone/Fax
| Phone: | 7606309922 |
| Fax: |
Provider Mailing Location
993 POSTAL WAY
VISTA
CA
920836945
Provider Mailing Phone/Fax
| Phone: | 7606309922 |
| Fax: |