Shepherd Medical Staffing Agency L.L.C.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

SHEPHERD MEDICAL STAFFING AGENCY L.L.C.

Doing business as

Shepherd Medical Laboratory

Practice address

1630 W Redlands Blvd Ste I
Redlands, CA 92373-8032

Phone

(909) 310-2145

NPI assigned

May 20, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Daniel Yeboah

Title

Owner

Phone

(951) 897-2517

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Shepherd Medical Laboratory Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1716163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716163200000",
    "number": "1619716859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 W REDLANDS BLVD STE I",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923738032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 W REDLANDS BLVD STE I",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923738032",
            "telephone_number": "909-310-2145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHEPHERD MEDICAL STAFFING AGENCY L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-20",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-19",
        "status": "A",
        "authorized_official_last_name": "YEBOAH",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "951-897-2517"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA CLINICAL LAB REGISTRATION",
            "identifier": "CLR-90012719",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "05D2304752",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shepherd Medical Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Victoria Nicole Shaw
• William Carey Shearer, PH.D., ED.D., M.B.A.
• Shellee Lazar MD Apc
• Ashley Nicole Shelley, RDH, RDHAP
• Celina W Shelton, D.P.T.
• Slade Stewart Shepherd, DDS
• Venice Amelia Sherman
• Carol Sherwood
• Yong-Han Shi, DPM
• Ronald Douglas Shiell, M.D.

• Clinical Medical Laboratory in Redlands, CA
• Providers in Redlands, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.