JERRY ALAN SHIELDS

SANTA ROSA, CA
NPI1982239901
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2020-03-10
Last Update Date2020-03-10
Business Address
JERRY ALAN SHIELDS
1550 N DUTTON AVE
SANTA ROSA, CA 95401-4601
Phone number: 707-236-6696
Mailing Address
JERRY ALAN SHIELDS
131 MADRIGAL ST
ROHNERT PARK, CA 94928-2316
Phone number: 707-318-8745