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LETITIA RENEE SHACKLEFORD-OLIVER
NPI 1730839085
Specialist/Technologist, Other in Vallejo, CA

Active since March 28, 2022
1628 BROADWAY ST, VALLEJO, CA 94590(077) 649-8300 Get Directions Write a Review

NPPES record last updated: March 28, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Letitia Renee Shackleford-oliver NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LETITIA RENEE SHACKLEFORD-OLIVER (NPI 1730839085) is an individual specialist/technologist, other provider in Vallejo, California and active in the NPI registry since March 2022.

NPPES Registry Identity

NPI1730839085
Entity TypeIndividualFemale
Primary Taxonomy246Z00000X
Provider Legal NameLETITIA RENEE SHACKLEFORD-OLIVER
Location Address1628 BROADWAY STVallejo, CA 94590-2405
Mailing Address1628 Broadway StVallejo, CA 94590-2405 · (077) 649-8300
Phone(077) 649-8300
Sole ProprietorNo
Enumeration DateMarch 28, 2022
NPPES CertifiedMarch 28, 2022
✔ NPI 1730839085 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialist/Technologist, OtherTechnologists, Technicians & Other Technical Service Providers
Taxonomy Code246Z00000X
Definition
General classification identifying individuals trained on specific equipment and technical procedures in one of a collection of miscellaneous healthcare disciplines.
1628 BROADWAY ST, Vallejo, CA 94590
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Other Identifiers 1

Other1479CA · Tower Id

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. DIANNE LYNN MILLER LVN
Licensed Vocational Nurse
1628 BROADWAY ST
VALLEJO, CA 94590
Solano County (707) 246-2783
MARQUITA KING
Counselor (Addiction (Substance Use Disorder))
1628 BROADWAY ST, B
VALLEJO, CA 94590
Solano County (707) 649-8300
AMINAH HIM
Licensed Vocational Nurse
1628 BROADWAY ST
VALLEJO, CA 94590
Solano County (707) 649-8300
CEOLA RENEE FARMER
Counselor (Addiction (Substance Use Disorder))
1628 BROADWAY ST
VALLEJO, CA 94590
Solano County (707) 649-8300
MS. PUNEET GREWAL
Licensed Vocational Nurse
1628 BROADWAY ST
VALLEJO, CA 94590
Solano County (707) 649-8300
KATHERINE FRANK CPT-1
Specialist/Technologist, Other
1628 BROADWAY ST
VALLEJO, CA 94590
Solano County (707) 649-8300
ZAIN SINGH NAGRA
Counselor (Addiction (Substance Use Disorder))
1628 BROADWAY ST
VALLEJO, CA 94590
Solano County (707) 649-8300
MEDMARK TREATMENT SERVICES, INC.
Clinic/Center (Methadone)
1628 BROADWAY ST
VALLEJO, CA 94590
Solano County (707) 649-8300

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Letitia Shackleford-oliver's NPI number?

The NPI number for Letitia Shackleford-oliver is 1730839085. It was assigned to this individual provider in the NPPES registry on March 28, 2022.

Where is Letitia Shackleford-oliver located?

Letitia Shackleford-oliver practices at 1628 Broadway St, Vallejo, CA 94590. The listed phone number is (077) 649-8300.

What is Letitia Shackleford-oliver's specialty?

The primary specialty registered for this NPI is Specialist/Technologist, Other with taxonomy code 246Z00000X.

When was this NPI record last updated?

The NPPES record for Letitia Shackleford-oliver was last updated on March 28, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.